| NPI | 1013633502 |
|---|---|
| Doing Business As | DENTA DENTAL OF ODESSA |
| Entity Type | Organization |
| Authorized Contact | LOI TA President 901-606-2355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2023-07-01 |