Michael Spataro, D.M.D

Individual provider Active NPI General Practice Dentistry · Montrose, PA

NPI 1083752158 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1083752158
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DS-031166-L (PA)
Practice address
48 Church St
Montrose, PA 18801-1255
Phone
(570) 278-3347
NPI assigned
Feb 2, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DS-031166-LPAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS-031166-L PA Yes

Addresses

Primary practice location

48 Church St
Montrose, PA 18801-1255

Mailing address

48 Church St
Montrose, PA 18801-1255
Phone (570) 278-3347

Other providers in Montrose, PA

All providers in Montrose, PA · General Practice Dentistry in Pennsylvania

Sources for this page

Verify at the official NPI Registry.