Individual
MATTHEW EDWARD IMBROGNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MSD
Contact information
Practice address
4106 WAKE FOREST RD STE 100, RALEIGH, NC 27609-6397
(919) 876-2464
(919) 876-1409
Mailing address
367 JUNIPER ISLAND DR, DEFUNIAK SPRINGS, FL 32433-3516
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
11944
NC
Other
Enumeration date
02/09/2020
Last updated
02/04/2025
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