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Organization
SCOTT NIGL DENTAL PC
Active
Organization
SCOTT NIGL DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON BERTOLLINI (PRM)
(866) 273-8204
Entity
Organization
Contact information
Practice address
4216 24TH AVE, STE 100, FORT GRATIOT, MI 48059-3880
(810) 984-8669
(810) 385-6157
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
(866) 273-8204
(866) 803-4943
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18564
MI
Other
Enumeration date
01/28/2015
Last updated
01/28/2015
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