Individual
DR. JOHN OTTESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
74 LONGVIEW DRIVE, MANCHESTER CENTER, VT 05255
(315) 761-5366
Mailing address
PO BOX 316, MANCHESTER, VT 05254-0316
(315) 280-4370
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
016.0086821
VT
Other
Enumeration date
02/07/2007
Last updated
11/05/2012
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