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General NPI Number Information
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NPI Number | 1396674339
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Entity Type | Organization
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Legal Business Name | ANDREA M. MATTIA DDS LLC
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Dates
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Enumeration Date | 05/15/2026
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Last Update Date | 05/15/2026
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Provider Practice Location Address
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Address Line | 175 OLD TAPPAN RD
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City | OLD TAPPAN
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State | NJ
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Zip | 07675-7042
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Country | US
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Telephone | 201-768-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 175 OLD TAPPAN RD
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City | OLD TAPPAN
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State | NJ
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Zip | 07675-7042
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Country | US
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Telephone | 201-768-7100
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Fax | 201-768-0183
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANDREA M MATTIA
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Credential | DDS
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Telephone | 201-768-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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