Individual
DR. TARA A MATTINGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1851 E BASELINE RD, 103, GILBERT, AZ 85233-1536
(480) 558-9000
Mailing address
1851 E BASELINE RD, 103, GILBERT, AZ 85233-1536
(480) 558-9000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
12011552A
IN
1223G0001X
General Practice Dentistry
Primary
D008266
AZ
Other
Enumeration date
10/15/2010
Last updated
08/17/2011
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