DR. Mary Matta, DDS

NPI #1790668465 in Lathrup Village, Michigan

Provider Information

NPI Number: 1790668465
Entity Type: Individual
Name: DR. Mary Matta, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Jul 29, 2025
Last Updated: Jul 29, 2025

Practice Location

Address: 18181 W 12 MILE RD STE 4
City: Lathrup Village
State: Michigan
ZIP Code: 48076-2666
Phone: (248) 557-5756

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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