Individual
KRISTAN NICOLE OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.A
Contact information
Practice address
12121 WILSHIRE BLVD, 1111, LOS ANGELES, CA 90025-1123
(310) 820-9933
(310) 820-0408
Mailing address
12121 WILSHIRE BLVD, 1111, LOS ANGELES, CA 90025-1123
(310) 820-9933
(310) 820-0408
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
D160110472
WA
Other
Enumeration date
06/05/2013
Last updated
06/05/2013
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