Provider Demographics
NPI:1790839066
Name:BOTTO, CHARLES F (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:F
Last Name:BOTTO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 N GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17551-1523
Mailing Address - Country:US
Mailing Address - Phone:717-872-7881
Mailing Address - Fax:717-872-7230
Practice Address - Street 1:323 N GEORGE ST
Practice Address - Street 2:
Practice Address - City:MILLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17551-1523
Practice Address - Country:US
Practice Address - Phone:717-872-7881
Practice Address - Fax:717-872-7230
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPA 017654L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice