Individual
DR. BRIAN L MATTIACIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
1386 HATHAWAY DR, FARMINGTON, NY 14425-8973
(585) 742-1050
(585) 742-1011
Mailing address
1386 HATHAWAY DR, FARMINGTON, NY 14425-8973
(585) 742-1050
(585) 742-1011
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
051528
NY
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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