Individual
DR. MARA INTA MATISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
437 STONE ST, KALAMAZOO, MI 49006-4530
(269) 345-5431
Mailing address
3988 MARIETTA CIR, KALAMAZOO, MI 49009-6579
(269) 544-0955
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901018157
MI
Other
Enumeration date
01/02/2007
Last updated
07/08/2007
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