# MICHAEL R. COTTAM MS DMD PLLC

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

## Provider details

- **NPI number:** 1679823058
- **Authorized official:** MICHAEL R COTTAM DMD (DENTIST)
- **Authorized official phone:** (801) 261-3178

## Contact information

- **Practice address:** 4775 W DAYBREAK PKWY, SOUTH JORDAN, UT 84095-5968
- **Practice address phone:** (801) 261-3178
- **Practice address fax:** (801) 268-1930
- **Mailing address:** 4775 W DAYBREAK PKWY, SOUTH JORDAN, UT 84095-5968
- **Mailing address phone:** (801) 261-3178
- **Mailing address fax:** (801) 268-1930

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 8296939-9923 | NULL | Yes |
| 1223P0221X | Pediatric Dentistry | 8296939-9923 | — | Yes |

## Other

- **Enumeration date:** 09/13/2012
- **Last updated:** 09/13/2012