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General NPI Number Information
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NPI Number | 1841415031
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Entity Type | Organization
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Legal Business Name | GERALD A. MATO, D.D.S., P.L.L.C.
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Dates
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Enumeration Date | 04/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1021 KARL GREIMEL DR SUITE 103
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City | BRIGHTON
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State | MI
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Zip | 48116-9465
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Country | US
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Telephone | 810-355-3500
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Fax | 810-355-3502
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Provider Business Mailing Address
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Address Line | 1021 KARL GREIMEL DR SUITE 103
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City | BRIGHTON
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State | MI
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Zip | 48116-9465
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Country | US
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Telephone | 810-355-3500
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Fax | 810-355-3502
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Authorized Official
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Title or Position | OWNER
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Name | DR. GERALD ANTHONY MATO
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Credential | D.D.S.
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Telephone | 810-355-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901017938
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License Number State | MI
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