Individual
DR. MICHAEL MATTINGLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3255 LYNDALE AVE S, MINNEAPOLIS, MN 55408-3647
(612) 822-8968
Mailing address
3255 LYNDALE AVE S, MINNEAPOLIS, MN 55408-3647
(612) 822-8968
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9998
MN
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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