# DR. JASON BRYCE BOTTS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1356417687
- **Gender:** Man
- **Credential:** DDS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 3586 | AR | — |
| 1223G0001X | General Practice Dentistry | DS0000008754 | TN | Yes |

## Other

- **Enumeration date:** 11/28/2006
- **Last updated:** 04/23/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 161133608 | — | AR |