Provider Demographics
NPI:1578930467
Name:HOTT FAMILY DENTISTRY LLC
Entity Type:Organization
Organization Name:HOTT FAMILY DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARTHOLOMEW
Authorized Official - Middle Name:LUKE
Authorized Official - Last Name:HOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:260-824-2442
Mailing Address - Street 1:PO BOX 432
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:IN
Mailing Address - Zip Code:46714-0432
Mailing Address - Country:US
Mailing Address - Phone:260-824-2442
Mailing Address - Fax:260-824-8101
Practice Address - Street 1:706 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:IN
Practice Address - Zip Code:46714-1312
Practice Address - Country:US
Practice Address - Phone:260-824-2442
Practice Address - Fax:260-824-8101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-26
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011131A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty