Nicole Mathew, DT

NPI #1073013322 in Minneapolis, Minnesota

Provider Information

NPI Number: 1073013322
Entity Type: Individual
Name: Nicole Mathew, DT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dental Therapist
Credential: DT
Enumeration Date: Feb 13, 2018
Last Updated: Feb 13, 2018

Practice Location

Address: 636 BROADWAY ST NE
City: Minneapolis
State: Minnesota
ZIP Code: 55413-2164
Phone: (612) 746-1530

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Therapist	125J00000X	Primary

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