Individual
DR. SHAWN KEVIN OTTESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4501 N 7TH ST, PHOENIX, AZ 85014-3804
(602) 845-5730
Mailing address
4501 N 7TH ST, PHOENIX, AZ 85014-3804
(602) 845-5730
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D009292
AZ
Other
Enumeration date
07/29/2015
Last updated
07/29/2015
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