Individual
DR. CHARLES F MATTINGLY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
409 VANDIVER DR, BLDG 3 SUITE 102, COLUMBIA, MO 65202-3754
(573) 499-1699
(573) 442-7897
Mailing address
211 W BRIARWOOD LN, COLUMBIA, MO 65203-1607
(573) 445-7298
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14178
MO
Other
Enumeration date
09/30/2005
Last updated
07/08/2007
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