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Individual

STEPHEN P MATTINGLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
805 EASTERN BY-PASS, SUITE #4, RICHMOND, KY 40475
(859) 623-0222
(859) 624-3440
Mailing address
805 EASTERN BY-PASS, SUITE #4, RICHMOND, KY 40475
(859) 623-0222
(859) 624-3440

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6125
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
60061256
KY
Enumeration date
09/28/2006
Last updated
07/08/2007
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