Individual
DR. SCOTT WILLIAM OTTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
146 CLARK RD, BLDG 339, USA DENTAL HEALTH ACTIVITY, FT SHAFTER, HI 96858
(808) 438-3990
Mailing address
6479 W CARRICK WAY, HIGHLAND, UT 84003-5526
(610) 202-5735
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
12667815-8903
UT
1223E0200X
Endodontics
Primary
12667815-9922
UT
1223E0200X
Endodontics
D-5561-EN
ID
Other
Enumeration date
09/02/2016
Last updated
10/16/2023
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