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Organization

PLEV, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JASON BERTOLLINI (PRM)
(866) 273-8204
Entity
Organization

Contact information

Practice address
G3538 MILLER RD, FLINT, MI 48507-1271
(810) 424-0400
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
(866) 803-4943
(866) 803-4943

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13084
MI

Other

Enumeration date
10/29/2013
Last updated
10/29/2013
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