Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 6005 | MT |
Y | 1223D0001X | Dental Public Health | 6005 | MT |
NPI | 1558794404 |
---|---|
Provider Name | Dr. Maria Bartoletti |
First Address | Butte, MT 59701-2870 |
Second Address | Butte, MT 59701-2870 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2013 |
Last Update Date | 14/08/2013 |