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Organization
PLEV BC PLC
Active
Organization
PLEV BC PLC
Active
Other names
Aspen Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JASON BERTOLLINI PRS (PROVIDER RELATIONS SPECIALIST)
(866) 273-8204
Entity
Organization
Contact information
Practice address
6600 WEIGHLOCK DR, EAST SYRACUSE, NY 13057
(866) 273-8204
(866) 803-4943
Mailing address
3505 WILDER RD STE A, BAY CITY, MI 48706-2173
(989) 895-6600
(989) 671-8907
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13084
MI
Other
Enumeration date
06/03/2014
Last updated
06/03/2014
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