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Individual

DR. TODD TAKEO MATSUMOTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S., M.S.

Contact information

Practice address
2635 GATEWAY RD STE 101, CARLSBAD, CA 92009-1753
(760) 444-4094
Mailing address
12481 S LA COSTE DR, TUSTIN, CA 92782-0943
(714) 783-8308

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
54489
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DE00007805
WA

Other

Enumeration date
04/19/2006
Last updated
12/13/2019
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