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Individual

TIFFANY OTTOSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
195 W 14TH, RIFLE, CO 81650-4700
(970) 625-5200
Mailing address
2009 ODIN DR, SILT, CO 81652-8776

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
903350
CO

Other

Enumeration date
12/05/2011
Last updated
12/05/2011
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