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Organization
MARK L O'DELL, DDS
Active
Organization
MARK L O'DELL, DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK L O'DELL DDS (DENTIST)
(989) 624-9381
Entity
Organization
Contact information
Practice address
7971 MAIN ST, BIRCH RUN, MI 48415-8001
(989) 624-9381
(989) 624-9353
Mailing address
7971 MAIN ST, PO BOX 460, BIRCH RUN, MI 48415-8001
(989) 624-9381
(989) 624-9353
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11334
MI
122300000X
Dentist
2901019315
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2926589
—
MI
Enumeration date
03/12/2009
Last updated
03/12/2009
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