Individual
DR. XAVIER MATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.S.
Contact information
Practice address
8608 S 30TH WAY, PHOENIX, AZ 85042-8249
(480) 268-1569
Mailing address
8608 S 30TH WAY, PHOENIX, AZ 85042-8249
(480) 268-1569
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
14245
MD
1223P0300X
Periodontics
60014
CA
1223P0300X
Periodontics
Primary
8075
AZ
Other
Enumeration date
08/08/2008
Last updated
06/18/2019
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