Larry D Otte, D.M.D.

NPI #1194859355 in Peoria, Illinois

Provider Information

NPI Number
1194859355
Entity Type
Individual
Name
Larry D Otte, D.M.D.
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Dentist - Oral and Maxillofacial Surgery
Credential
D.M.D.
Enumeration Date
Mar 16, 2007
Last Updated
Oct 2, 2008

Practice Location

Address
2807 N KNOXVILLE AVE
City
Peoria
ZIP Code
61604-2869
Phone
(309) 682-1213

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice
Dentist - Oral and Maxillofacial SurgeryOral and Maxillofacial Surgery

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Organizations

Provider Name
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