# DR. MARK LEE O'DELL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1962481424
- **Gender:** Man
- **Credential:** DDS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 11334 | MI | Yes |

## Other

- **Enumeration date:** 01/12/2006
- **Last updated:** 07/13/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2926589 | — | MI |
| 01 | — | 479934 | UNITED CONCORDIA | MI |
| 01 | — | J113340 | BC/BS OF MI | MI |