Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. MATT R AGNEW, DMD
ActiveDental Public Health · SUN PRAIRIE, WI
Registration Details
- NPI Number
- 1295916419
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 15, 2007 (18.43184716384 yrs)
- Last Updated
- May 4, 2021
- License
-
6179-15 (WI)
Practice Information
- Address
-
1270 W MAIN STSUN PRAIRIE, WI, 535901930Browse WI providers · Browse ZIP 53590
- Phone
- 6084435482
- Fax
- 6088379134
- Primary Specialty
-
Dental Public Health
1223D0001X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.