Provider Demographics
NPI:1356465942
Name:TERRY W OTT DDS INC
Entity Type:Organization
Organization Name:TERRY W OTT DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:WENDALL
Authorized Official - Last Name:OTT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-218-7811
Mailing Address - Street 1:6750 WEST LOOP SOUTH
Mailing Address - Street 2:STE 400
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401
Mailing Address - Country:US
Mailing Address - Phone:713-218-7811
Mailing Address - Fax:713-218-7833
Practice Address - Street 1:6750 WEST LOOP SOUTH
Practice Address - Street 2:STE 400
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401
Practice Address - Country:US
Practice Address - Phone:713-218-7811
Practice Address - Fax:713-218-7833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113321223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty