| NPI | 1528673365 |
|---|---|
| Doing Business As | OTTER TAIL DENTAL |
| Entity Type | Organization |
| Authorized Contact | SONJA ANN JOHNSON Business Manager 218-739-3245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2020-09-09 |