# CONDON DENTAL SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CONDON DENTAL SERVICES, PS
- **Other names:** Odessa Dental Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1871548925
- **Legal business name:** CONDON DENTAL SERVICES, PS
- **Authorized official:** MICHAEL P CONDON DR (OWNER)
- **Authorized official phone:** (509) 982-2605

## Contact information

- **Practice address:** 20 W 1ST, ODESSA, WA 99159-0459
- **Practice address phone:** (509) 982-2605
- **Practice address fax:** (509) 982-9951
- **Mailing address:** PO BOX 429, 20 W FIRST, ODESSA, WA 99159-0429
- **Mailing address phone:** (509) 982-2605
- **Mailing address fax:** (509) 982-9951

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 8440 | WA | Yes |

## Other

- **Enumeration date:** 05/24/2006
- **Last updated:** 11/02/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5054358 | — | WA |