MEDICARE: DR. OLA MICHAEL SITTO DDS

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	14464	MI

General Provider Information

NPI Number	:	1396850392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OLA MICHAEL SITTO DDS

Provider Business Mailing Address
First Line	:	5830 N LAPEER RD
Second Line	:	STE A
City	:	NORTH BRANCH
State	:	MI
Zip	:	48461
Country	:	US
Telephone Number	:	810-793-7800
Fax Number	:

Provider Business Practice Location Address
First Line	:	5830 N LAPEER RD
Second Line	:
City	:	NORTH BRANCH
State	:	MI
Zip	:	48461
Country	:	US
Telephone Number	:	810-793-7800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	07/20/2020

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