Individual
DR. MATHEW THOMAS KATTADIYIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BDS
Contact information
Practice address
11092 ANDERSON STREET, LOMA LINDA, CA 92354
(909) 554-4613
(909) 558-4192
Mailing address
11092 ANDERSON STREET, LOMA LINDA, CA 92354
(909) 554-4613
(909) 558-4192
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
45275
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45275
STATE LICENSE
CA
Enumeration date
04/13/2007
Last updated
07/08/2007
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