Dr. John Ottesen, DDS
Dentist in Manchester Center, VT. Individual provider (NPI-1).
NPI number1316087828
StatusActive
Last updated in NPPESNov 5, 2012
Details
- NPI
- 1316087828
- Entity type
- Individual (NPI-1)
- Name
- Dr. John Ottesen
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 7, 2007
- Last updated
- Nov 5, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 016.0086821 | VT | Yes |
Practice location
74 Longview DriveManchester Center, VT 05255
Phone 315-761-5366
Mailing address
Po Box 316Manchester, VT 05254-0316
Phone 315-280-4370
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