Provider Demographics
NPI:1134104870
Name:COTEY, ANGELA M (DDS)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:COTEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:RIDGELY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1730 SPRINGDALE ST
Mailing Address - Street 2:
Mailing Address - City:MT HOREB
Mailing Address - State:WI
Mailing Address - Zip Code:53572
Mailing Address - Country:US
Mailing Address - Phone:608-437-7645
Mailing Address - Fax:
Practice Address - Street 1:1730 SPRINGDALE ST
Practice Address - Street 2:
Practice Address - City:MT HOREB
Practice Address - State:WI
Practice Address - Zip Code:53572
Practice Address - Country:US
Practice Address - Phone:608-437-7645
Practice Address - Fax:608-437-7649
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5915-015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist