Organization
DR. SCOTT THOMAS ODOM, A PROFESSIONAL CORPORATION
Active
Other names
Scott T. Odom DDS, PC
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT ODOM (PRESIDENT)
(337) 593-9989
Entity
Organization
Contact information
Practice address
1315 SURREY ST, LAFAYETTE, LA 70501-7617
(337) 593-9989
Mailing address
1315 SURREY ST, LAFAYETTE, LA 70501-7617
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4901
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1849014
—
LA
Enumeration date
12/15/2011
Last updated
12/15/2011
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