Individual
TRACY LYNNE MATHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
471 HEPBURN ST, WILLIAMSPORT, PA 17701-6122
(570) 567-5431
Mailing address
526 SOUTHMONT AVE, SOUTH WILLIAMSPORT, PA 17702-7745
(570) 974-6002
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH069304
PA
Other
Enumeration date
10/17/2017
Last updated
10/17/2017
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