Organization
DRS. OTTOSEN AND NYGARD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN R. OTTOSEN DDS, MSD (OWNER)
(509) 664-6669
Entity
Organization
Contact information
Practice address
1001 W BROADWAY AVE, MOSES LAKE, WA 98837-2604
(509) 766-8968
(509) 766-8967
Mailing address
1001 W BROADWAY AVE, MOSES LAKE, WA 98837-2604
(509) 766-8968
(509) 766-8967
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
604-034-843
WA
Other
Enumeration date
10/10/2016
Last updated
10/10/2016
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