| Jason L. Mantey Dds Pllc | |
|
10680 E Carter Rd Traverse City MI 49684-5437 | |
| (269) 986-3782 | |
| Not Available |
| Full Name | Jason L. Mantey Dds Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 10680 E Carter Rd, Traverse City, Michigan |
| Authorized Official Name and Position | Jason Luke Mantey (OWNER) |
| Authorized Official Contact | 2699863782 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jason L. Mantey Dds Pllc 10680 E Carter Rd Traverse City MI 49684-5437 Ph: (269) 986-3782 | Jason L. Mantey Dds Pllc 10680 E Carter Rd Traverse City MI 49684-5437 Ph: (269) 986-3782 |
| NPI Number | 1376107193 |
|---|---|
| Provider Enumeration Date | 04/26/2019 |
| Last Update Date | 04/26/2019 |
| Medicare PECOS PAC ID | 2769724780 |
|---|---|
| Medicare Enrollment ID | O20190423002007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376107193 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Jason L Mantey |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1376803981 PECOS PAC ID: 7113219304 Enrollment ID: I20190517001349 |
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