Provider Demographics
NPI:1942328190
Name:OTA, STEVEN M (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:M
Last Name:OTA
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:3440 LOMITA BLVD
Mailing Address - Street 2:SUITE 434
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4801
Mailing Address - Country:US
Mailing Address - Phone:310-530-5144
Mailing Address - Fax:310-530-7972
Practice Address - Street 1:3440 LOMITA BLVD
Practice Address - Street 2:SUITE 434
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4801
Practice Address - Country:US
Practice Address - Phone:310-530-5144
Practice Address - Fax:310-530-7972
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA374711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice