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Larry D Otte, DMD
Oral and Maxillofacial Surgery (Dentist) in Peoria, Illinois
NPI 1194859355

Larry D Otte is a Oral and Maxillofacial Surgery (Dentist) based in Peoria, IL and is specialized in Oral and Maxillofacial Surgery. Larry D Otte practices in Peoria, IL and has the professional credentials of DMD. The NPI Number for Larry D Otte is 1194859355 and holds a License No. 019-024407 (Illinois).

The current practice location address for Larry D Otte is 2807 N Knoxville Ave, Peoria, IL and can be reached out via phone at 309-682-1213. You can also correspond with Larry D Otte through the mailing address at 2807 N KNOXVILLE AVE, PEORIA, IL - 61604-2869 (mailing address contact number: 309-682-1213).

Location: 2807 N Knoxville Ave, Peoria, IL, 61604-2869
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1194859355
Provider Name
Larry D Otte
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
2807 N Knoxville Ave, Peoria, IL, 61604-2869
Phone Number
309-682-1213
Fax Number
Provider Enumeration Date
03/16/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
909830 01 IL MEDICARE PT10
institution
Provider Business Practice Location Address Details
Address
2807 N Knoxville Ave
City
Peoria
State
Illinois
Zip
61604-2869
Phone Number
309-682-1213
Fax Number
person
Provider Business Mailing Address Details
Address
2807 N Knoxville Ave
City
Peoria
State
Illinois
Zip
61604-2869
Phone Number
309-682-1213
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
021-001850 (Illinois)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
person
Provider's Taxonomy Details 2
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
019-024407 (Illinois)
Definition
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
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