Organization
OTTER KIDS PEDIATRIC DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH JOHN OTTERSTEDT DDS (OWNER)
(719) 867-5500
Entity
Organization
Contact information
Practice address
1155 KELLY JOHNSON BLVD, STE 210, COLORADO SPRINGS, CO 80920
(719) 867-0550
(719) 867-3191
Mailing address
1294 OAKMONT DR, COLORADO SPRINGS, CO 80921-3762
(719) 867-0550
(719) 867-3191
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
10/30/2024
Last updated
10/30/2024
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