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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295732337 NPPES
Arizona Other 094136 AHCCCS PROVIDER ID

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