Individual
MATTHEW FLETCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
105 E 10TH AVE, POST FALLS, ID 83854-5125
(208) 773-8388
Mailing address
4937 E PORTSIDE CT, POST FALLS, ID 83854-7105
(801) 623-2688
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-4590
ID
Other
Enumeration date
07/15/2014
Last updated
07/15/2014
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