Individual
DR. DAVID A MATTINGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
850 FAIRWAY DR, CHILLICOTHE, MO 64601-3673
(660) 646-3802
(660) 646-3887
Mailing address
850 FAIRWAY DR, CHILLICOTHE, MO 64601-3673
(660) 646-3802
(660) 646-3887
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2010016136
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1841519105
—
MO
Enumeration date
05/26/2010
Last updated
05/10/2011
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