Provider Demographics
NPI:1801216262
Name:MICHAEL BITTRICH, DMD, PC
Entity Type:Organization
Organization Name:MICHAEL BITTRICH, DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BITTRICH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-385-5150
Mailing Address - Street 1:900 ROUTE 134
Mailing Address - Street 2:
Mailing Address - City:SOUTH DENNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02660-2575
Mailing Address - Country:US
Mailing Address - Phone:508-385-5150
Mailing Address - Fax:508-385-3435
Practice Address - Street 1:900 ROUTE 134
Practice Address - Street 2:
Practice Address - City:SOUTH DENNIS
Practice Address - State:MA
Practice Address - Zip Code:02660-2575
Practice Address - Country:US
Practice Address - Phone:508-385-5150
Practice Address - Fax:508-385-3435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN16094122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty