Individual
MARIEL COTTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
840 ADMIRAL WEINEL BLVD, COLUMBIA, IL 62236-1992
(618) 281-2929
Mailing address
1224 GREENFIELD PL APT 311, O FALLON, IL 62269-7299
(815) 540-7711
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
021002798
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
2017005019
MO
Other
Enumeration date
05/16/2017
Last updated
05/16/2017
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