Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 98 | OK |
NPI | 1063563757 |
---|---|
Provider Name | Dr. Terry L Cotterell |
First Address | Midwest City, OK 73130 |
Second Address | Midwest City, OK 73130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 08/07/2007 |