| NPI | 1851683510 |
|---|---|
| Former Name | GENEVIEVE MARIE OTTO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MO 2010040607) |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2026-02-03 |