# MARK A MASTELLOTTO DDSPC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588398333
- **Authorized official:** DEBBIE J WATTERS (OFFICE MANAGER)
- **Authorized official phone:** (517) 263-0338

## Contact information

- **Practice address:** 760 RIVERSIDE AVE, ADRIAN, MI 49221-1445
- **Practice address phone:** (517) 263-0338
- **Practice address fax:** (517) 263-1138
- **Mailing address:** 760 RIVERSIDE AVE, ADRIAN, MI 49221-1445
- **Mailing address phone:** (517) 263-0338
- **Mailing address fax:** (517) 263-1138

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 292200000X | Dental Laboratory | — | NULL | Yes |

## Other

- **Enumeration date:** 07/15/2022
- **Last updated:** 07/15/2022