Individual
DR. MARY MATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
18181 W 12 MILE RD STE 4, LATHRUP VILLAGE, MI 48076-2666
(248) 557-5756
Mailing address
201 RED MILL DR, INKSTER, MI 48141-1699
(313) 424-3251
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901602769
MI
Other
Enumeration date
07/29/2025
Last updated
07/29/2025
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