| Denta Dental Of Odessa Pllc | |
|
1508 N Grandview Ave Ste 3 Odessa TX 79761-3040 | |
| (432) 367-8907 | |
| (432) 362-0949 |
| Full Name | Denta Dental Of Odessa Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1508 N Grandview Ave Ste 3, Odessa, Texas |
| Authorized Official Name and Position | Loi Ta (PRESIDENT) |
| Authorized Official Contact | 9016062355 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Denta Dental Of Odessa Pllc 1508 N Grandview Ave Ste 3 Odessa TX 79761-3040 Ph: (432) 367-8907 | Denta Dental Of Odessa Pllc 1508 N Grandview Ave Ste 3 Odessa TX 79761-3040 Ph: (432) 367-8907 |
| NPI Number | 1013633502 |
|---|---|
| Provider Enumeration Date | 10/17/2022 |
| Last Update Date | 07/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013633502 | NPI | - | NPPES |
| 1912491218 | Other | TX | NPI I |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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