Individual
OTTO WILLIAM DOHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS,MS
Contact information
Practice address
1142 W CAPITOL AVE, BISMARCK, ND 58501-1306
(702) 222-8760
(701) 222-3162
Mailing address
1142 W CAPITOL AVE, BISMARCK, ND 58501-1306
(702) 222-8760
(701) 222-3162
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
1766
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41031
—
ND
01
—
901766
DSC IDENTIFIER
ND
Enumeration date
04/17/2007
Last updated
07/08/2007
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