Provider Demographics
NPI:1467536672
Name:BARTLETT, MILLARD MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:MILLARD
Middle Name:MICHAEL
Last Name:BARTLETT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14700 BAUER DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-3622
Mailing Address - Country:US
Mailing Address - Phone:301-460-9090
Mailing Address - Fax:301-460-6207
Practice Address - Street 1:14700 BAUER DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20853-3622
Practice Address - Country:US
Practice Address - Phone:301-460-9090
Practice Address - Fax:301-460-6207
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD5886122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist