Individual
DR. MISAEL JOSUE OTERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
509 OLDE WATERFORD WAY, SUITE 300, LELAND, NC 28451-4125
(910) 383-0100
Mailing address
1208 CAROLINA BEACH AVE N APT 2B, CAROLINA BEACH, NC 28428-6096
(910) 458-4559
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8019
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5901132
—
NC
Enumeration date
09/20/2006
Last updated
07/08/2007
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