Individual
DR. MATTHEW THOMAS MATTEUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2764 LAKE SAHARA DR, LAS VEGAS, NV 89117-3400
(702) 365-6497
Mailing address
2764 LAKE SAHARA DR, LAS VEGAS, NV 89117-3400
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6100
PA
122300000X
Dentist
Primary
DS038718
PA
332BC3200X
Customized Equipment (DME)
6100
NV
Other
Enumeration date
06/23/2011
Last updated
07/23/2026
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