Organization
DAVID BASTIANELLI, DDS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHERIE ANN MARTIN (OFFICE MANAGER)
(248) 644-6688
Entity
Organization
Contact information
Practice address
522 E LINCOLN ST, BIRMINGHAM, MI 48009-1791
(248) 644-6688
(248) 644-3470
Mailing address
522 E LINCOLN ST, BIRMINGHAM, MI 48009-1791
(248) 644-6688
(248) 644-3470
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
135470
MI
Other
Enumeration date
01/25/2016
Last updated
01/25/2016
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