MEDICARE: DR. MICHAEL SCOTT BARTLETT, DDS, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist

General Provider Information

NPI Number	:	1366878753
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. MICHAEL SCOTT BARTLETT, DDS, PC

Provider Business Mailing Address
First Line	:	3140 CENTRAL MALL DR
Second Line	:
City	:	PORT ARTHUR
State	:	TX
Zip	:	77642-8039
Country	:	US
Telephone Number	:	409-727-2164
Fax Number	:	409-727-5222

Provider Business Practice Location Address
First Line	:	3140 CENTRAL MALL DR
Second Line	:
City	:	PORT ARTHUR
State	:	TX
Zip	:	77642-8039
Country	:	US
Telephone Number	:	409-727-2164
Fax Number	:	409-727-5222

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. MICHAEL SCOTT BARTLETT
Credential	:	DDS
Telephone Number	:	409-727-2164

Provider Enumeration Date	:	09/18/2013
Last Update Date	:	09/18/2013

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