Provider Demographics
NPI:1043913338
Name:MATTSON, EMMA RILEY (DMD)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:RILEY
Last Name:MATTSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BRIARWOOD LN
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02770-1848
Mailing Address - Country:US
Mailing Address - Phone:774-849-2916
Mailing Address - Fax:
Practice Address - Street 1:6 BRIARWOOD LN
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02770-1848
Practice Address - Country:US
Practice Address - Phone:774-849-2916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health