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Organization
EAGLE DENTAL P.C.
Active
Organization
EAGLE DENTAL P.C.
Active
Parent organization
SUN DENTAL GROUP P.A.
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUN DENTAL GROUP P.A.
Authorized official
DR. DAVIN E ODIA DDS (OWNER)
(832) 790-2223
Entity
Organization
Contact information
Practice address
12609 S GESSNER DR, HOUSTON, TX 77071-2803
(713) 774-6700
(713) 774-6704
Mailing address
12609 S. GESSNER DRIVE, STE. F, HOUSTON, TX 77071-2803
(713) 774-6700
(713) 774-6704
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22575
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190960801
—
TX
05
—
214288701
—
TX
01
—
B22575-01
CHIP
—
01
—
B22575-02
CHIP
—
Enumeration date
05/27/2010
Last updated
06/23/2011
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