Most Relevant Information
Provider Data
| NPI Number: | 1003077413 |
| Provider Name: | OTTO JAMES TOR DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 1223G0001X |
| Specialty: | Dentist |
| License Number: | 019.014420 |
Most Important Dates
| Enumeration Date: | 06/18/2008 |
| Last Updated: | 06/18/2008 |
Provider Practice Location
15614 S HARLEM AVE
SUITE A
ORLAND PARK
IL
604624402
Practice Location Phone/Fax
| Phone: | 7086141111 |
| Fax: |
Provider Mailing Location
15614 S HARLEM AVE
SUITE A
ORLAND PARK
IL
604624402
Provider Mailing Phone/Fax
| Phone: | 7086141111 |
| Fax: |