Individual
DR. DAVID BRUCE OTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
125 N PANSY STREET, ISHPEMING, MI 49849-3015
(906) 485-5575
(906) 485-1260
Mailing address
1000 ALLENEZ RD, MARQUETTE, MI 49855
(906) 485-5575
(906) 485-1260
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901016005
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4616262
—
MI
Enumeration date
10/26/2006
Last updated
07/08/2007
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