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1073621355
RANDY E OTTESON
PORTLAND, OR
NPI
1073621355
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist General Practice
(Licence: OR 6192)
Enumeration Date
2006-08-28
Last Update Date
2007-07-08
Business Address
DR. RANDY E OTTESON DMD
5312 SE 52ND AVE
PORTLAND, OR 97206
Phone number: 503-775-7117
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Mailing Address
DR. RANDY E OTTESON DMD
5312 SE 52ND AVE
PORTLAND, OR 97206
Phone number: 503-775-7117
Copy
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