Individual
MS. JAYNE MATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2669 N. 92ND ST., MILWAUKEE, WI 53226
(414) 258-2216
(414) 258-9466
Mailing address
944 S 58TH STREET, WEST ALLIS, WI 53214
(414) 771-9083
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6043015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33804100
—
WI
Enumeration date
05/16/2007
Last updated
09/14/2015
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