| David Bastianelli, Dds, Pllc | |
|
522 E Lincoln St Birmingham MI 48009-1791 | |
| (248) 644-6688 | |
| (248) 644-3470 |
| Full Name | David Bastianelli, Dds, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 522 E Lincoln St, Birmingham, Michigan |
| Authorized Official Name and Position | Cherie Ann Martin (OFFICE MANAGER) |
| Authorized Official Contact | 2486446688 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David Bastianelli, Dds, Pllc 522 E Lincoln St Birmingham MI 48009-1791 Ph: (248) 644-6688 | David Bastianelli, Dds, Pllc 522 E Lincoln St Birmingham MI 48009-1791 Ph: (248) 644-6688 |
| NPI Number | 1609233402 |
|---|---|
| Provider Enumeration Date | 01/25/2016 |
| Last Update Date | 01/25/2016 |
| Medicare PECOS PAC ID | 0042519621 |
|---|---|
| Medicare Enrollment ID | O20160810001776 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609233402 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 135470 (Michigan) | Primary |
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