Provider Demographics
NPI:1023144219
Name:OTTENRITTER, VERNON F JR (DDS)
Entity type:Individual
Prefix:DR
First Name:VERNON
Middle Name:F
Last Name:OTTENRITTER
Suffix:JR
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 1:106 OLD PADONIA ROAD
Mailing Address - Street 2:
Mailing Address - City:COCKEYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21030
Mailing Address - Country:US
Mailing Address - Phone:410-628-0118
Mailing Address - Fax:410-628-0357
Practice Address - Street 1:106 OLD PADONIA ROAD
Practice Address - Street 2:
Practice Address - City:COCKEYSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21030
Practice Address - Country:US
Practice Address - Phone:410-628-0118
Practice Address - Fax:410-628-0357
Is Sole Proprietor?:No
Enumeration Date:2007-02-24
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD73551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice