Healthcare Provider Details

I. General information

NPI: 1396850392
Provider Name (Legal Business Name): OLA MICHAEL SITTO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 07/20/2020
Certification Date: 07/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5830 N LAPEER RD
NORTH BRANCH MI
48461
US

IV. Provider business mailing address

5830 N LAPEER RD STE A
NORTH BRANCH MI
48461
US

V. Phone/Fax

Practice location:
  • Phone: 810-793-7800
  • Fax:
Mailing address:
  • Phone: 810-793-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number14464
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: