Individual
DR. EDWARD J. MATSUMOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5153 N CLARK ST, SUITE 208, CHICAGO, IL 60640-6823
(773) 271-7176
(773) 271-9908
Mailing address
5153 N CLARK ST, SUITE 208, CHICAGO, IL 60640-6823
(773) 271-7176
(773) 271-9908
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
07/31/2006
Last updated
07/08/2007
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