Most Relevant Information
Provider Data
| NPI Number: | 1003034976 |
| Provider Name: | KEITH S MATTINSON DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 1223G0001X |
| Specialty: | Dentist |
| License Number: | 1449899922 |
Most Important Dates
| Enumeration Date: | 04/23/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
1172 E 100 N
SUITE # 3
PAYSON
UT
846511667
Practice Location Phone/Fax
| Phone: | 8014655000 |
| Fax: |
Provider Mailing Location
1172 E 100 N
SUITE # 3
PAYSON
UT
846511667
Provider Mailing Phone/Fax
| Phone: | 8014655000 |
| Fax: |