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General NPI Number Information
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NPI Number | 1023266954
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Entity Type | Organization
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Legal Business Name | OTERO & OTERO DDS PA
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Dates
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Enumeration Date | 09/04/2008
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Last Update Date | 09/04/2008
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Provider Practice Location Address
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Address Line | 14057 US HIGHWAY 17 SUITE 120
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City | HAMPSTEAD
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State | NC
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Zip | 28443
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Country | US
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Telephone | 910-270-9344
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Fax |
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Provider Business Mailing Address
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Address Line | 14057 US HIGHWAY 17 SUITE 120
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City | HAMPSTEAD
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State | NC
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Zip | 28443
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Country | US
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Telephone | 910-270-9344
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Fax |
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Authorized Official
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Title or Position | DENTIST, OWNER
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Name | DR. MISAEL J OTERO
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Credential | DDS
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Telephone | 910-270-9344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 8058
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 8019
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License Number State | NC
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