Leonard R Odham Jr DDS PA

NPI #1063556587 in Fair Bluff, North Carolina

Provider Information

NPI Number: 1063556587
Entity Type: Organization
Organization Name: Leonard R Odham Jr DDS PA
Primary Specialty: Dentist
Enumeration Date: Feb 16, 2007
Last Updated: May 29, 2012

Practice Location

Address: 16 POWELL ST
City: Fair Bluff
State: North Carolina
ZIP Code: 28439
Phone: (910) 649-7222

Authorized Official

Name: DR. LEONARD RUSSELL ODHAM JR., DDS
Title: PRES
Phone: (910) 649-1222

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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