Provider Demographics
NPI:1144609538
Name:KOTTMAN, MEGAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:
Last Name:KOTTMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4218 HOOVER RD
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-3625
Mailing Address - Country:US
Mailing Address - Phone:614-539-2702
Mailing Address - Fax:614-539-2796
Practice Address - Street 1:4218 HOOVER RD
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-3625
Practice Address - Country:US
Practice Address - Phone:614-539-2702
Practice Address - Fax:614-539-2796
Is Sole Proprietor?:No
Enumeration Date:2015-05-19
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.024460122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist