Matt R Agnew, DMD Valid NPI
Individual provider · Public Health Dentistry · Sun Prairie, WI
- NPI
- 1295916419
- Type
- Individual (Type 1)
- Primary specialty
- Public Health Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223D0001X
- License number
- 6179-15 (WI)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2007-11-15
- Last updated
- 2021-05-04
Practice location
1270 W Main St
Sun Prairie, WI 53590-1930
(608) 443-5482