Provider Demographics
NPI:1912971060
Name:MATTEI, HERBERT F (DMD)
Entity Type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:F
Last Name:MATTEI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:525 AVE FD ROOSEVELT
Mailing Address - Street 2:LA TORRE DE PLAZA LAS AMERICAS 710
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-8001
Mailing Address - Country:US
Mailing Address - Phone:787-764-2300
Mailing Address - Fax:787-753-6320
Practice Address - Street 1:525 AVE FD ROOSEVELT
Practice Address - Street 2:LA TORRE DE PLAZA LAS AMERICAS 710
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-8001
Practice Address - Country:US
Practice Address - Phone:787-764-2300
Practice Address - Fax:787-753-6320
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR672OtherDENTAL LICENSE