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Provider Information for 1457382350



DAVID MATTO DMD

Gender: MALE

Individual NPI: 1457382350

Calendar Last Updated: 2007-07-08

Details

Name Value
NPI 1457382350
Enumeration Date 2006-07-06
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 555 W BENJAMIN HOLT DR BUIILDING B
STOCKTON, CA 95207-3839
United States

Phone: 209-476-4700 | Fax:
View Map External Link
Primary Practice Address 95-1249 MEHEULA PKWY SUITE A-12
MILILANI, HI 96789-1779
United States

Phone: 808-623-2888 | Fax:
View Map External Link
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice HI 2155
Other Identifiers
Issuer State Number
Endpoint Information
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location