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Individual
JOHN J OTTEN
Active
Individual
JOHN J OTTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019-023700
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
021-001773
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
30317
NE
Other
Enumeration date
03/16/2007
Last updated
03/17/2018
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