Mattern, Thomas Michael
Mattern, Thomas Michael is an sole proprietor health care provider with primary practice located at 4609 E Chandler Blvd , Phoenix AZ 85048-0424. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Mattern, Thomas Michael can be contacted via phone (480) 706-4600.Contact Information
Primary practice address
4609 E Chandler Blvd
Phoenix AZ 85048-0424
Phone: (480) 706-4600
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | D3892 | Arizona |
Profile Details
| NPI number | 1295732337 |
|---|---|
| LBN Legal business name | Mattern, Thomas Michael |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 5th, 2005 |
| Last updated | May 21st, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295732337 | NPPES |
| Arizona | Other | 094136 | AHCCCS PROVIDER ID |
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