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Individual

DR. ALICE M. OTTAVI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
2232 HENNEPIN AVE, MINNEAPOLIS, MN 55405-2737
(612) 377-6108
(612) 374-1820
Mailing address
2232 HENNEPIN AVE, MINNEAPOLIS, MN 55405-2737
(612) 377-6108
(612) 374-1820

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9919
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0015210
DORAL DENTAL
MN
01
1727
HEALTH PARTNERS
MN
01
46092 DE
BLUE CROSS BLUE SHIELD
MN
01
978483
UNITED CONCORDIA
MN
Enumeration date
07/25/2006
Last updated
07/09/2007
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