| Joseph B. Otto Dds, P.c. | |
|
400 Fairview Ave Ste 1 Ponca City OK 74601-1910 | |
| (580) 765-6633 | |
| (580) 765-0803 |
| Full Name | Joseph B. Otto Dds, P.c. |
|---|---|
| Speciality | Dentist |
| Location | 400 Fairview Ave Ste 1, Ponca City, Oklahoma |
| Authorized Official Name and Position | Joseph Balzer Otto (OWNER) |
| Authorized Official Contact | 5807656633 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Joseph B. Otto Dds, P.c. 400 Fairview Ave Ste 1 Ponca City OK 74601-1910 Ph: (580) 765-6633 | Joseph B. Otto Dds, P.c. 400 Fairview Ave Ste 1 Ponca City OK 74601-1910 Ph: (580) 765-6633 |
| NPI Number | 1578748547 |
|---|---|
| Provider Enumeration Date | 01/08/2008 |
| Last Update Date | 01/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578748547 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 4550 (Oklahoma) | Primary |
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