Provider Demographics
NPI:1366878753
Name:DR. MICHAEL SCOTT BARTLETT, DDS, PC
Entity type:Organization
Organization Name:DR. MICHAEL SCOTT BARTLETT, DDS, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:BARTLETT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:409-727-2164
Mailing Address - Street 1:3140 CENTRAL MALL DR
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-8039
Mailing Address - Country:US
Mailing Address - Phone:409-727-2164
Mailing Address - Fax:409-727-5222
Practice Address - Street 1:3140 CENTRAL MALL DR
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-8039
Practice Address - Country:US
Practice Address - Phone:409-727-2164
Practice Address - Fax:409-727-5222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty