Individual
ELISE ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.A
Contact information
Practice address
2701 S 77 SUNSHINESTRIP, HARLINGEN, TX 78550-8318
(956) 430-9355
(956) 430-9373
Mailing address
105 DICKEY ST, FORT POLK, LA 71459-3546
(956) 430-9355
(956) 430-9373
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
35682
TX
Other
Enumeration date
03/22/2017
Last updated
03/22/2017
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