Individual
DR. JAIME MATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3620 S BRISTOL ST, STE.306, SANTA ANA, CA 92704-7300
(714) 556-5156
(714) 556-5151
Mailing address
3620 S BRISTOL ST, STE. 306, SANTA ANA, CA 92704-7300
(714) 556-5156
(714) 556-5151
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
30612
CA
Other
Enumeration date
05/29/2007
Last updated
07/08/2007
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