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Mark A. Mastellotto
Dental Clinic/Center in Adrian, Michigan
NPI 1972211134

Mark A. Mastellotto is a Dental Clinic/Center based in Adrian, MI and is specialized in Dental. Mark A. Mastellotto practices in Adrian, MI. The NPI Number for Mark A. Mastellotto is 1972211134 and holds a License No. (Michigan).

The current practice location address for Mark A. Mastellotto is 760 Riverside Ave, Adrian, MI and can be reached out via phone at 517-263-0338 and via fax at 517-263-1138.

Location: 760 Riverside Ave, Adrian, MI, 49221-1445
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1972211134
Provider Name
Mark A. Mastellotto
Credential
Provider Entity Type
Organization
Address
760 Riverside Ave, Adrian, MI, 49221-1445
Phone Number
517-263-0338
Fax Number
517-263-1138
Provider Enumeration Date
11/07/2022
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1013077601 01 ALL INSURANCE
1013077601 01 MI ALL INSURANCE
1013077601 05 MI
1013077601 01 MI DENTAL
institution
Provider Business Practice Location Address Details
Address
760 Riverside Ave
City
Adrian
State
Michigan
Zip
49221-1445
Phone Number
517-263-0338
Fax Number
517-263-1138
person
Provider Business Mailing Address Details
Address
760 Riverside Ave
City
Adrian
State
Michigan
Zip
49221-1445
Phone Number
517-263-0338
Fax Number
517-263-1138
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
()
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
261QD0000X
License No.
()
Definition
Definition to come...
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