Organization
OTTO AND KOTECKI FAMILY DENTISTRY PLC
Active
Other names
Weber and Otto Family Dentistry PLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JERALYN G. HUISMAN (PRACTICE COORDINATOR)
(641) 424-6461
Entity
Organization
Contact information
Practice address
3223 4TH ST SW, MASON CITY, IA 50401-1583
(641) 424-6461
(641) 424-9186
Mailing address
3223 4TH ST SW, MASON CITY, IA 50401-1583
(641) 424-6461
(641) 424-9186
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0212191
—
IA
Enumeration date
10/04/2006
Last updated
06/15/2023
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