Individual
MATTHEW BLUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
202 E BIRCH ST, ABBOTSFORD, WI 54405-9439
(715) 223-4844
Mailing address
908 W NORTH ST, MARSHFIELD, WI 54449-1820
(480) 721-0887
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1001782-15
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2017
Last updated
12/16/2021
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