Provider Demographics
NPI:1457353922
Name:COTTRELL, DAVID MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:COTTRELL
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 1:7343 EL CAMINO REAL
Mailing Address - Street 2:SUITE 350
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-4697
Mailing Address - Country:US
Mailing Address - Phone:805-459-0862
Mailing Address - Fax:
Practice Address - Street 1:1505 SHEPARD DR
Practice Address - Street 2:SUITE 201
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-7020
Practice Address - Country:US
Practice Address - Phone:805-922-2888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA352391223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry