Organization
JOSEPH B. OTTO DDS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH BALZER OTTO D.D.S. (OWNER)
(580) 765-6633
Entity
Organization
Contact information
Practice address
400 FAIRVIEW AVE STE 1, PONCA CITY, OK 74601-1910
(580) 765-6633
(580) 765-0803
Mailing address
400 FAIRVIEW AVE STE 1, PONCA CITY, OK 74601-1910
(580) 765-6633
(580) 765-0803
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4550
OK
Other
Enumeration date
01/08/2008
Last updated
01/08/2008
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