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Individual

MATTHEW IDLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FRCS(OMFS)

Contact information

Practice address
3366 OAKDALE AVE N, ROBBINSDALE, MN 55422-2948
(763) 581-5360
Mailing address
3366 OAKDALE AVE N, ROBBINSDALE, MN 55422-2948
(763) 581-5360

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
R640
MN

Other

Enumeration date
08/03/2016
Last updated
08/03/2016
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