Individual
RISA LEIGHANN ODUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
23 FAYETTE ST, MARTINSVILLE, VA 24112-2703
(276) 632-7727
Mailing address
23 FAYETTE ST, MARTINSVILLE, VA 24112-2703
(276) 632-7727
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401412519
VA
Other
Enumeration date
06/29/2009
Last updated
06/29/2009
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