Individual
DR. MATTHEW SCHNETTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3750 W OGDEN AVE, CHICAGO, IL 60623-2426
(872) 588-3220
Mailing address
353 N DESPLAINES ST APT 1802, CHICAGO, IL 60661-1351
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019031791
IL
1223G0001X
General Practice Dentistry
019.031791
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019031791
STATE LICENSE
IL
01
—
319021145
CDS
IL
Enumeration date
07/26/2018
Last updated
03/07/2023
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