Individual
BRYAN J. OTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4957 SWINYAR DR, OOLTEWAH, TN 37363-2204
(423) 396-3154
(423) 396-3154
Mailing address
4957 SWINYAR DR, OOLTEWAH, TN 37363-2204
(423) 396-3154
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10597
TN
Other
Enumeration date
07/25/2017
Last updated
07/25/2017
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