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Dr. Matthew Charles Mandeville, DDS
Pediatric Dentist in Traverse City, Michigan
NPI 1598812422

Matthew Charles Mandeville is a Pediatric Dentist based in Traverse City, MI and is specialized in Pediatric Dentistry. Matthew Charles Mandeville practices in Traverse City, MI and has the professional credentials of DDS. The NPI Number for Matthew Charles Mandeville is 1598812422 and holds a License No. 2901015862 (Michigan).

The current practice location address for Matthew Charles Mandeville is 4944 Skyview Ct, Traverse City, MI and can be reached out via phone at 231-947-4566.

Location: 4944 Skyview Ct, Traverse City, MI, 49684-7173
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1598812422
Provider Name
Matthew Charles Mandeville
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
4944 Skyview Ct, Traverse City, MI, 49684-7173
Phone Number
231-947-4566
Fax Number
Provider Enumeration Date
01/04/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2974192 05 MI
D158620 01 MI BLUE CROSS BLUE SHIELD MI
institution
Provider Business Practice Location Address Details
Address
4944 Skyview Ct
City
Traverse City
State
Michigan
Zip
49684-7173
Phone Number
231-947-4566
Fax Number
person
Provider Business Mailing Address Details
Address
4944 Skyview Ct
City
Traverse City
State
Michigan
Zip
49684-7173
Phone Number
231-947-4566
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
2901015862 (Michigan)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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