Provider Demographics
NPI:1710019203
Name:BARTOLETTI, MIKE JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:MIKE
Middle Name:JOSEPH
Last Name:BARTOLETTI
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 1:1501 HOLMES AVE
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-3325
Mailing Address - Country:US
Mailing Address - Phone:406-494-5003
Mailing Address - Fax:
Practice Address - Street 1:1501 HOLMES AVE
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-3325
Practice Address - Country:US
Practice Address - Phone:406-494-5003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT16421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice