# EAGLE DENTAL CORP INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dr Steve Carson and Dr Mary Mary Martin
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235141029
- **Authorized official:** DR. MARY E MARTIN DDS (CEO VICE PRESIDENT)
- **Authorized official phone:** (405) 732-6821

## Contact information

- **Practice address:** 6520 EAST RENO, MIDWEST CITY, OK 73110-2109
- **Practice address phone:** (405) 732-6821
- **Practice address fax:** (405) 732-7970
- **Mailing address:** 6520 EAST RENO, MIDWEST CITY, OK 73110-2109
- **Mailing address phone:** (405) 732-6821
- **Mailing address fax:** (405) 732-7970

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 4594 | OK | Yes |
| 122300000X | Dentist | 4609 | OK | — |

## Other

- **Enumeration date:** 08/12/2006
- **Last updated:** 08/22/2020