Individual
DR. MATTHEW C CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS PC
Contact information
Practice address
3520 UTICA RIDGE ROAD, BETTENDORF, IA 52722
(563) 359-9165
(563) 359-1824
Mailing address
3520 UTICA RIDGE ROAD, BETTENDORF, IA 52722
(563) 359-9165
(563) 359-1824
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7854
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144162
—
IA
Enumeration date
03/30/2006
Last updated
08/27/2012
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