Individual
COURTNEY BOTICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
417 RIDGE RD STE A, MUNSTER, IN 46321-1571
(219) 836-9841
Mailing address
417 RIDGE RD STE A, MUNSTER, IN 46321-1571
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12012576A
IN
Other
Enumeration date
08/03/2016
Last updated
08/03/2016
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