Individual
KELLY MATHESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
475 KEENE RD, RICHLAND, WA 99352-5007
(509) 627-6888
(509) 627-6720
Mailing address
3801 FAIRFAX DR, ARLINGTON, VA 22203-1762
(703) 527-3554
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401412425
VA
122300000X
Dentist
Primary
DE00010940
WA
Other
Enumeration date
09/14/2007
Last updated
08/09/2022
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