National Provider Identifier
Brian L Mattiacio, D.D.S., M.S.
Brian L Mattiacio, D.D.S., M.S. is listed in the NPPES registry with a primary specialty of Orthodontics and Dentofacial Orthopedics Dentistry in Farmington, NY and a listed phone number of (585) 742-1050.
Profile Overview
- NPI
- 1922129261
- Provider Type
- Individual
- Primary Specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- Enumeration Date
- April 03, 2007
- Last Updated
- July 08, 2007
Practice Location
- 1386 Hathaway Dr
- Farmington, NY 14425-8973
Phone: (585) 742-1050
Specialties
- Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X)
Full Record
- NPI
- 1922129261
- Entity Type
- Individual
- Last Name
- Mattiacio
- First Name
- Brian
- Middle Name
- L
- Name Prefix
- Dr.
- Credential
- D.D.S., M.S.
- Mailing Street Address
- 1386 Hathaway Dr
- Mailing City
- Farmington
- Mailing State
- NY
- Mailing ZIP Code
- 14425-8973
- Mailing Country
- US
- Mailing Phone
- (585) 742-1050
- Mailing Fax
- (585) 742-1011
- Practice Street Address
- 1386 Hathaway Dr
- Practice City
- Farmington
- Practice State
- NY
- Practice ZIP Code
- 14425-8973
- Practice Country
- US
- Practice Phone
- (585) 742-1050
- Practice Fax
- (585) 742-1011
- Enumeration Date
- April 03, 2007
- Last Updated
- July 08, 2007
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X)