Individual
DR. JUSTIN EDWARD OTTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2255 LEE ST SW, WYOMING, MI 49519-1670
(616) 532-0501
(616) 532-0501
Mailing address
2255 LEE ST SW, WYOMING, MI 49519-1670
(616) 532-0501
(616) 532-0501
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901012543
MI
Other
Enumeration date
02/03/2007
Last updated
07/08/2007
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