| NPI | 1750583514 |
|---|---|
| Other Name | JON MICHAEL DEMATTEIS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 029149) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2007-07-08 |