Individual
MICHAEL OTTAVIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1828 W LAKE AVE, NEPTUNE, NJ 07753-4663
(732) 869-5716
Mailing address
53 WALL ST, EATONTOWN, NJ 07724-2451
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DI02689500
NJ
Other
Enumeration date
08/30/2017
Last updated
09/29/2025
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