Individual
MICHAEL D. OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3223 4TH ST SW, MASON CITY, IA 50401-1583
(641) 424-6461
Mailing address
30 BURR OAK LN, MASON CITY, IA 50401-1400
(641) 423-6675
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
08229
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0212191
—
IA
05
—
0295303
—
IA
Enumeration date
04/04/2007
Last updated
07/09/2007
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