NPI 1194256115

Elise Odom, RDA

Practitioner Dental Assistant Harlingen, TX

Practice location

Address: 2701 S 77 Sunshinestrip, Harlingen, TX 78550-8318
Phone: (956) 430-9355
Fax: (956) 430-9373
Mailing address: 105 Dickey St, Fort Polk, LA 71459-3546

Registered specialties

Dental Assistant Primary

Dental Providers Taxonomy 126800000X Licence 35682 (TX)

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Registry record

NPI: 1194256115
Entity type: Individual
Sex (as registered): Female
NPI issued: 22 Mar 2017
Record last updated: 22 Mar 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.