Individual
ANNETTE F MATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS, MPH
Contact information
Practice address
4624 LAKEVIEW PKWY, ROWLETT, TX 75088-4027
(972) 840-2020
Mailing address
5270 N O CONNOR BLVD APT 1207, IRVING, TX 75039-5717
(281) 935-6072
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
18836
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000000
NONE
TX
Enumeration date
03/16/2011
Last updated
02/04/2022
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