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MATTESON IMPLANT AND RECONSTRUCTIVE DENTISTRY PC. NPI 1679096523


NPI Information

NPI: 1679096523
Provider Name: MATTESON IMPLANT AND RECONSTRUCTIVE DENTISTRY PC.

Doing Business As: LAKEVIEW DENTAL

Classification: Dentist - 1223P0700X
Entity Type: Organization

Specialization: Prosthodontics

Address:
801 W MILWAUKEE DR
COEUR D ALENE, ID
ZIP 83814
Phone: (208) 664-0884
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MATTESON IMPLANT AND RECONSTRUCTIVE DENTISTRY PC. is a prosthodontics dentist in Coeur D Alene, ID. The provider is that branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. MATTESON IMPLANT AND RECONSTRUCTIVE DENTISTRY PC. NPI is 1679096523. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Lakeview Dental.

The provider's business location address is:

801 W MILWAUKEE DR
COEUR D ALENE, ID
ZIP 83814-236
Phone: (208) 664-0884

The provider's authorized official is Alvin Brett Matteson .
The authorized official title is Owner/ Prosthodontist and has the following contact phone number (270) 853-2508.

The enumeration date for this NPI number is 7/24/2017 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1122300000XDentistD-4027IDAHONo
21223P0700XDentistProsthodonticsD-4027IDAHOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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