NPI 1073013322

Nicole Mathew, DT

Practitioner Dental Therapist Minneapolis, MN

Practice location

Address: 636 Broadway St NE, Minneapolis, MN 55413-2164
Phone: (612) 746-1530
Fax: (612) 746-1531

Registered specialties

Dental Therapist Primary

Dental Providers Taxonomy 125J00000X Licence DT96 (MN)

Other Dental Therapist providers in Minnesota →

Registry record

NPI: 1073013322
Entity type: Individual
Sex (as registered): Female
NPI issued: 13 Feb 2018
Record last updated: 13 Feb 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.