Organization
ODESSA FAMILY DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD HENDRICKS (CREDENTIALING)
(612) 859-0444
Entity
Organization
Contact information
Practice address
404 N 4TH ST, ODESSA, MO 64076-1152
(816) 633-5393
Mailing address
404 N 4TH ST, ODESSA, MO 64076-1152
(816) 633-5393
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/01/2025
Last updated
10/01/2025
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