Mario Bartoletti, DMD

Individual provider Active NPI Dentist · Butte, MT

NPI 1447634407 · NPPES record last updated Jul 18, 2015

Key facts

NPI
1447634407
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
DEN-DEN-LIC-9609 (MT)
Practice address
445 Centennial Ave
Butte, MT 59701-2870
Phone
(406) 565-0951
NPI assigned
Jul 18, 2015
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160331002260 MT Order and Referring Only - Dentist
Practitioner - Dentist
6709183098

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
DEN-DEN-LIC-9609MTMDDentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN-DEN-LIC-9609 MT Yes

Addresses

Primary practice location

445 Centennial Ave
Butte, MT 59701-2870

Mailing address

445 Centennial Ave
Butte, MT 59701-2870
Phone (406) 565-0951

Other providers in Butte, MT

All providers in Butte, MT · Dentist in Montana

Sources for this page

Verify at the official NPI Registry.