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Organization
EAGLE DENTAL CORP INC
Active
Organization
EAGLE DENTAL CORP INC
Active
Other names
Dr Steve Carson and Dr Mary Mary Martin
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY E MARTIN DDS (CEO VICE PRESIDENT)
(405) 732-6821
Entity
Organization
Contact information
Practice address
6520 EAST RENO, MIDWEST CITY, OK 73110-2109
(405) 732-6821
(405) 732-7970
Mailing address
6520 EAST RENO, MIDWEST CITY, OK 73110-2109
(405) 732-6821
(405) 732-7970
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4594
OK
122300000X
Dentist
4609
OK
Other
Enumeration date
08/12/2006
Last updated
08/22/2020
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