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Individual

ROBERT L. OTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
2515 S.E. 179TH AVE., PORTLAND, OR 97236-1035
(503) 761-5610
(503) 761-9072
Mailing address
2515 S.E. 179TH AVE., PORTLAND, OR 97236-1035
(503) 761-5610
(503) 761-9072

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4075
OR

Other

Enumeration date
11/06/2012
Last updated
11/06/2012
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