Individual
MS. MICHELE L OTT
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 B STREET, PLUMMER, ID 83851-0388
(208) 686-1931
(208) 686-0242
Mailing address
141 TRINITY LN, ST MARIES, ID 83861-9342
(208) 686-1110
(208) 686-0242
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
10/04/2005
Last updated
07/08/2007
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