Individual
KOLVER MATOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
N112W16286 MEQUON RD, GERMANTOWN, WI 53022-3306
(262) 725-4085
Mailing address
3757 E GRANGE AVE, CUDAHY, WI 53110-2363
(815) 762-5655
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1002358-15
WI
Other
Enumeration date
04/28/2020
Last updated
07/13/2020
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