Organization
J A MASTROMATTEO DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH ANTHONY MASTROMATTEO DDS (PRESIDENT)
(248) 693-1331
Entity
Organization
Contact information
Practice address
312 S BROADWAY ST, LAKE ORION, MI 48362-2794
(248) 693-1331
(248) 693-1385
Mailing address
312 S BROADWAY ST, LAKE ORION, MI 48362-2794
(248) 693-1331
(248) 693-1385
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
JM008259
MI
Other
Enumeration date
02/14/2013
Last updated
10/08/2013
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