Organization
EAGLE DENTAL CORP INC
Active
Other names
Dr Steve Carson and Dr Mary Mary Martin
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY E MARTIN DDS (CEO VICE PRESIDENT)
(405) 732-6821
Entity
Organization
Contact information
Practice address
6520 EAST RENO, MIDWEST CITY, OK 73110-2109
(405) 732-6821
(405) 732-7970
Mailing address
6520 EAST RENO, MIDWEST CITY, OK 73110-2109
(405) 732-6821
(405) 732-7970
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4594
OK
122300000X
Dentist
4609
OK
Other
Enumeration date
08/12/2006
Last updated
08/22/2020
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