Organization
EAGLE DENTAL P.C.
Active
Parent organization
SUN DENTAL GROUP P.A.
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUN DENTAL GROUP P.A.
Authorized official
DR. DAVIN E ODIA DDS (OWNER)
(832) 790-2223
Entity
Organization
Contact information
Practice address
12609 S GESSNER DR, HOUSTON, TX 77071-2803
(713) 774-6700
(713) 774-6704
Mailing address
12609 S. GESSNER DRIVE, STE. F, HOUSTON, TX 77071-2803
(713) 774-6700
(713) 774-6704
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22575
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190960801
—
TX
05
—
214288701
—
TX
01
—
B22575-01
CHIP
—
01
—
B22575-02
CHIP
—
Enumeration date
05/27/2010
Last updated
06/23/2011
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