Individual
DR. MATT A MLSNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1301 N ALPINE RD, ROCKFORD, IL 61107-2262
(815) 397-4280
(815) 484-2436
Mailing address
1259 KRUPKE RD, CALEDONIA, IL 61011-9567
(815) 765-1989
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
08/08/2006
Last updated
07/08/2007
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