# JOSEPH B. OTTO DDS, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578748547
- **Authorized official:** JOSEPH BALZER OTTO D.D.S. (OWNER)
- **Authorized official phone:** (580) 765-6633

## Contact information

- **Practice address:** 400 FAIRVIEW AVE STE 1, PONCA CITY, OK 74601-1910
- **Practice address phone:** (580) 765-6633
- **Practice address fax:** (580) 765-0803
- **Mailing address:** 400 FAIRVIEW AVE STE 1, PONCA CITY, OK 74601-1910
- **Mailing address phone:** (580) 765-6633
- **Mailing address fax:** (580) 765-0803

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 4550 | OK | Yes |

## Other

- **Enumeration date:** 01/08/2008
- **Last updated:** 01/08/2008