Justin Edward Otten in Wyoming - General Practice
Justin Edward Otten - NPI 1659419273
Justin Edward Otten is a General Practice in Wyoming, Michigan. Justin Edward Otten practices all healthcare services and medical treatments related to General Practice. The NPI Number for Justin Edward Otten is 1659419273. The last update date is 2007-07-08.
Justin Edward Otten's current location address is 2255 Lee St Sw, Wyoming, Michigan. You can contact this provider via phone number 6165320501 and fax number 6165320501. The mailing address for Justin Edward Otten is 2255 Lee St Sw, Wyoming, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Justin Edward Otten |
|---|---|
| Address | 2255 Lee St Sw, Wyoming, Michigan |
| Phone Number | 6165320501 |
| Fax Number | 6165320501 |
| Sole Proprietor | Y |
| Credentials | D.D.S. |
NPI Number Detail
| NPI Number | 1659419273 |
|---|---|
| Provider Enumeration Date | 2007-02-03 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2255 Lee St Sw |
|---|---|
| City | Wyoming |
| State | Michigan (MI) |
| Post Code | 495191670 |
| Phone Number | 6165320501 |
| Fax Number | 6165320501 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 2901012543 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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What is the unique 10-digit identifier code assigned to Justin Edward Otten by the Centers for Medicare & Medicaid Services?
The Justin Edward Otten has been issued the NPI (National Provider Identifier) 1659419273 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete street address where Justin Edward Otten is physically located?
The Justin Edward Otten is physically situated at the following address: 2255 Lee St Sw, Wyoming, MI, 495191670.
What is Justin Edward Otten's specialized field of practice, and what is the corresponding taxonomy classification code?
The Justin Edward Otten's area of specialization is General Practice, and the corresponding taxonomy code that categorizes this field of practice is 1223G0001X.
On what date did the Justin Edward Otten receive its 1659419273 assignment from the Centers for Medicare & Medicaid Services?
The Justin Edward Otten was assigned its 1659419273 by the Centers for Medicare & Medicaid Services on 2007-02-03.
As of what date were the details related to Justin Edward Otten most recently updated or revised?
The information pertaining to Justin Edward Otten, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.
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