Individual
MR. CHARLES W MATTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1855 DAIMLER RD, ROCKFORD, IL 61112
(815) 397-7717
(815) 397-7719
Mailing address
1855 DAIMLER RD, ROCKFORD, IL 61112
(815) 397-7717
(815) 397-7719
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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