Individual
DR. DANA ERIC OTTERHOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
104 N 15TH ST, MOUNT VERNON, WA 98273-3405
(360) 424-9045
Mailing address
4002 RIDGE WAY, MOUNT VERNON, WA 98273-9452
(360) 424-8804
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4962
WA
Other
Enumeration date
06/03/2006
Last updated
07/08/2007
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