MEDICARE: DR. MICHAEL R COTTER D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	049762	NY
2	1223E0200X	Endodontics	9784	SC

General Provider Information

NPI Number	:	1326131236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL R COTTER D.D.S.

Provider Business Mailing Address
First Line	:	3070 N HIGHWAY 17 STE 200
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29466-9300
Country	:	US
Telephone Number	:	843-654-1410
Fax Number	:	843-654-1411

Provider Business Practice Location Address
First Line	:	3070 N HIGHWAY 17 STE 200
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29466-9300
Country	:	US
Telephone Number	:	843-654-1410
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	03/12/2024

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Directions to “ DR. MICHAEL R COTTER D.D.S.” Practice Location

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