Individual
MRS. TAMMY M MATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2 RUBIN DR, RUSHVILLE, NY 14544-9681
(585) 554-6824
Mailing address
5160 PARRISH STREET EXT, CANANDAIGUA, NY 14424-9002
(585) 394-4557
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
025383
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00618199
—
NY
Enumeration date
09/03/2008
Last updated
09/03/2008
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