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Individual

BEN OTTOSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
36000 SHOEMAKER LANE, SUITE 1051, FORT HOOD, TX 76544
(254) 286-7402
Mailing address
36000 SHOEMAKER LANE, SUITE 1051, FORT HOOD, TX 76544

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
30.025584
OH
1223P0300X
Periodontics
Primary
30.025584
OH

Other

Enumeration date
09/19/2018
Last updated
08/14/2025
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