Individual
CHRISTOPHER MICHAEL DE LA MATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3833 COON RAPIDS BLVD NW STE 220, COON RAPIDS, MN 55433-2597
(763) 421-6271
(763) 421-6273
Mailing address
3867 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-2518
(763) 586-0070
(763) 586-0072
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
D12752
MN
Other
Enumeration date
02/14/2007
Last updated
01/11/2021
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