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Individual

MICHAEL MOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
402 E BALDWIN AVE, PAULDING, OH 45879
(419) 399-3394
Mailing address
PO BOX 359, PAULDING, OH 45879
(419) 399-3394

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30017678
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0801725
OH
Enumeration date
05/24/2013
Last updated
05/24/2013
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