Individual
MARK PAUL BORTOLUSSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
213 EAST MICHIGAN AVE, MARSHALL, MI 49068
(269) 781-1108
(269) 781-9164
Mailing address
213 EAST MICHIGAN AVE, MARSHALL, MI 49068
(269) 781-1108
(269) 781-9164
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901016722
MI
Other
Enumeration date
08/22/2006
Last updated
07/08/2007
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