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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MATTESON IMPLANT AND RECONSTRUCTIVE DENTISTRY PC.

Active Organization

MATTESON IMPLANT AND RECONSTRUCTIVE DENTISTRY PC. is a Pediatric Dentistry organization located in COEUR D ALENE, Idaho. NPI 1679096523 is currently active in the NPPES registry. Verify at CMS.

Pediatric Dentistry · COEUR D ALENE, ID

Registration Details

NPI Number
1679096523
Provider Type
Organization
NPI Issued
Jul 24, 2017 (9.0690103993375 yrs)
Last Updated
Jul 21, 2022
Licenses
D-4027 (ID)
D-4027 (ID)

Practice Information

Address
801 W MILWAUKEE DR
COEUR D ALENE, ID, 838142236
Browse ID providers · Browse ZIP 83814
Phone
2086640884
Primary Specialty
Pediatric Dentistry
1223P0700X
Additional Specialty
Pediatric Dentistry
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.