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1023189131
MARIVIN OTO
MERIDIAN, ID
NPI
1023189131
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: ID D3750)
Enumeration Date
2006-11-11
Last Update Date
2007-07-09
Business Address
Dr. MARIVIN OTO DDS
317 W CHERRY LN
MERIDIAN, ID 83642-1608
Phone number: 208-888-2055
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Mailing Address
Dr. MARIVIN OTO DDS
317 W CHERRY LN
MERIDIAN, ID 83642-1608
Phone number: 208-888-2055
Copy
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