Individual
MRS. LACI DELEE OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
120 S DENTON TAP RD, COPPELL, TX 75019-3297
(469) 635-1105
Mailing address
300 EAST HWY 3040 APT #1733, LEWISVILLE, TX 75067
(940) 465-1556
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
14038
TX
Other
Enumeration date
03/12/2007
Last updated
07/08/2007
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