Organization
MARK A. MASTELLOTTO
Active
Organization
MARK A. MASTELLOTTO
Active
Other names
Mark Mastellotto DDS PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK ARTHUR MASTELLOTTO DDS (OWNER)
(517) 263-0338
Entity
Organization
Contact information
Practice address
760 RIVERSIDE AVE, ADRIAN, MI 49221-1445
(517) 263-0338
(517) 263-1138
Mailing address
760 RIVERSIDE AVE, ADRIAN, MI 49221-1445
(517) 263-0338
(517) 263-1138
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013077601
ALL INSURANCE
MI
05
—
1013077601
—
MI
Enumeration date
11/07/2022
Last updated
11/07/2022
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