Individual
DR. MARILYN BETTY MATHEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
751 MALLET HILL RD, APT 4208, COLUMBIA, SC 29223-4471
(845) 702-0581
Mailing address
751 MALLET HILL RD, APT 4208, COLUMBIA, SC 29223-4471
(845) 702-0581
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1001024-15
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831483650
—
WI
Enumeration date
06/09/2011
Last updated
09/09/2016
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