Organization
DENTA DENTAL OF ODESSA PLLC
Active
Other names
Denta Dental of Odessa
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOI TA DDS (PRESIDENT)
(901) 606-2355
Entity
Organization
Contact information
Practice address
1508 N GRANDVIEW AVE STE 3, ODESSA, TX 79761-3040
(432) 367-8907
(432) 362-0949
Mailing address
1508 N GRANDVIEW AVE STE 3, ODESSA, TX 79761-3040
(432) 367-8907
(432) 362-0949
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912491218
NPI I
TX
Enumeration date
10/17/2022
Last updated
07/01/2023
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