Provider Demographics
NPI:1184839219
Name:RUSS J ORTISI DDS & ANTHONY C ABATE DDS PLLC
Entity Type:Organization
Organization Name:RUSS J ORTISI DDS & ANTHONY C ABATE DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSS
Authorized Official - Middle Name:J
Authorized Official - Last Name:ORTISI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:586-978-2250
Mailing Address - Street 1:13801 15 MILE
Mailing Address - Street 2:SUITE E
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312
Mailing Address - Country:US
Mailing Address - Phone:586-978-2250
Mailing Address - Fax:586-978-2580
Practice Address - Street 1:13801 15 MILE
Practice Address - Street 2:SUITE E
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312
Practice Address - Country:US
Practice Address - Phone:586-978-2250
Practice Address - Fax:586-978-2580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty