Individual
DR. MATTHEW PAUL TICOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
11521 US HIGHWAY 431 STE V, GUNTERSVILLE, AL 35976-5671
(256) 505-8954
Mailing address
11521 US HIGHWAY 431 STE V, GUNTERSVILLE, AL 35976-5671
(256) 505-8954
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D.0005747
AL
1223P0221X
Pediatric Dentistry
DN16460
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201595
—
AL
Enumeration date
01/30/2007
Last updated
03/17/2018
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