| Mortiere & Gasparotto Dds Pc | |
|
5958 N Canton Center Rd Ste 600 Canton MI 48187-2766 | |
| (734) 459-1950 | |
| (734) 459-5710 |
| Full Name | Mortiere & Gasparotto Dds Pc |
|---|---|
| Speciality | Dentist |
| Location | 5958 N Canton Center Rd Ste 600, Canton, Michigan |
| Authorized Official Name and Position | Robert Callisto Gasparotto (VICE PRESIDENT) |
| Authorized Official Contact | 7344591950 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mortiere & Gasparotto Dds Pc 5958 N Canton Center Rd Ste 600 Canton MI 48187-2766 Ph: (734) 459-1950 | Mortiere & Gasparotto Dds Pc 5958 N Canton Center Rd Ste 600 Canton MI 48187-2766 Ph: (734) 459-1950 |
| NPI Number | 1194813535 |
|---|---|
| Provider Enumeration Date | 10/11/2006 |
| Last Update Date | 07/08/2019 |
| Medicare PECOS PAC ID | 6901131994 |
|---|---|
| Medicare Enrollment ID | O20190712002040 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194813535 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 014843 (Michigan) | Primary |
| Provider Name | Robert Callisto Gasparotto |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1497825962 PECOS PAC ID: 8628370905 Enrollment ID: I20190715001475 |
| Provider Name | Paul J Mortiere |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1497825103 PECOS PAC ID: 8022311562 Enrollment ID: I20190715001624 |
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