Individual
DR. MARCELO BARBOSA DE ACCIOLY MATTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
800 ROSE ST, LEXINGTON, KY 40536-4325
(859) 323-7595
Mailing address
800 ROSE ST # D104, LEXINGTON, KY 40536-7001
(859) 323-7595
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10400
KY
1223G0001X
General Practice Dentistry
125
NE
Other
Enumeration date
08/27/2018
Last updated
02/14/2020
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