| Mark A. Mastellotto | |
|
760 Riverside Ave Adrian MI 49221-1445 | |
| (517) 263-0338 | |
| (517) 263-1138 |
| Full Name | Mark A. Mastellotto |
|---|---|
| Speciality | Clinic/center |
| Location | 760 Riverside Ave, Adrian, Michigan |
| Authorized Official Name and Position | Mark Arthur Mastellotto (OWNER) |
| Authorized Official Contact | 5172630338 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark A. Mastellotto 760 Riverside Ave Adrian MI 49221-1445 Ph: (517) 263-0338 | Mark A. Mastellotto 760 Riverside Ave Adrian MI 49221-1445 Ph: (517) 263-0338 |
| NPI Number | 1972211134 |
|---|---|
| Provider Enumeration Date | 11/07/2022 |
| Last Update Date | 11/07/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972211134 | NPI | - | NPPES |
| 1013077601 | Other | ALL INSURANCE | |
| 1013077601 | Other | MI | ALL INSURANCE |
| 1013077601 | Medicaid | MI | |
| 1013077601 | Other | MI | DENTAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
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