Individual
DR. MATTHEW JAMES MIDTLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
840 N. 87TH STREETH, SARGEANT HEALTH CENTER, MILWAUKEE, WI 53226
(414) 805-5760
(414) 259-9115
Mailing address
1910 NORHARDT DR, #105, BROOKFIELD, WI 53045-5089
(651) 402-6593
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
7269
WI
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
7269
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497098255
—
WI
Enumeration date
03/30/2013
Last updated
10/03/2014
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