Odessa Mall Fdc Pa is a Dentist in Odessa, Texas. Odessa Mall Fdc Pa practices all healthcare services and medical treatments related to Dentist. The NPI Number for Odessa Mall Fdc Pa is 1801054044. The last update date is 2008-05-23.
Odessa Mall Fdc Pa's current location address is 4101 E 42nd, Odessa, Texas. You can contact this provider via phone number 4323634867 and fax number 4323631799. The mailing address for Odessa Mall Fdc Pa is 4101 E 42nd, Odessa, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Odessa Mall Fdc Pa |
|---|---|
| Address | 4101 E 42nd, Odessa, Texas |
| Phone Number | 4323634867 |
| Fax Number | 4323631799 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | REGIONAL M |
|---|---|
| Authorized Official Name | Armstrong Lynn |
| Telephone Number | 5053284867 |
NPI Number Detail
| NPI Number | 1801054044 |
|---|---|
| Provider Enumeration Date | 2008-05-23 |
| Last Updated Date | 2008-05-23 |
Provider Mailing Address Detail
| Address | 4101 E 42nd |
|---|---|
| City | Odessa |
| State | Texas (TX) |
| Post Code | 797627239 |
| Phone Number | 4323634867 |
| Fax Number | 4323631799 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 8481 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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What is the unique 10-digit identifier code assigned to Odessa Mall Fdc Pa by the Centers for Medicare & Medicaid Services?
The Odessa Mall Fdc Pa has been issued the NPI (National Provider Identifier) 1801054044 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you share the physical location details of Odessa Mall Fdc Pa?
The Odessa Mall Fdc Pa is situated at 4101 E 42Nd, in the city of Odessa, state of TX, with the zip code 797627239.
What is Odessa Mall Fdc Pa's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Odessa Mall Fdc Pa is Dentist, and the taxonomy classification code that categorizes this area of expertise is 122300000X.
When did Odessa Mall Fdc Pa receive its 1801054044 assignment?
The Odessa Mall Fdc Pa was assigned its 1801054044 on 2008-05-23, which is the date when this unique identifier was issued to the organization.
As of what date were the details related to Odessa Mall Fdc Pa most recently updated or revised?
The information pertaining to Odessa Mall Fdc Pa, including its address, specialty, and other relevant details, was last updated or revised on 2008-05-23.