Individual
ARTEM MATATOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
711 BOSTON POST RD, OLD SAYBROOK, CT 06475-2125
(860) 388-0242
Mailing address
9825 65TH RD APT 4A, REGO PARK, NY 11374-3510
(929) 370-7098
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN26396
FL
Other
Enumeration date
08/30/2021
Last updated
09/08/2021
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