Dr. Oluwaseun Odutola
Dentist in New Hartford, NY. Individual provider (NPI-1).
NPI number1164043410
StatusActive
Last updated in NPPESDec 4, 2021
Details
- NPI
- 1164043410
- Entity type
- Individual (NPI-1)
- Name
- Dr. Oluwaseun Odutola
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 28, 2020
- Certification date
- Dec 4, 2021
- Last updated
- Dec 4, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 062186 | NY | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | NY |
Practice location
4754 Commercial Dr Ste 2New Hartford, NY 13413-6205
Phone 315-768-7799
Mailing address
4754 Commercial Dr Ste 2New Hartford, NY 13413-6205
Phone 315-768-7799
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