Eagle Dental Corp INC
NPI #1235141029 in Midwest City, Oklahoma
Provider Information
- NPI Number
- 1235141029
- Entity Type
- Organization
- Organization Name
- Eagle Dental Corp INC
- Primary Specialty
- Dentist
- Enumeration Date
- Aug 12, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 6520 EAST RENO
- City
- Midwest City
- State
- Oklahoma
- ZIP Code
- 73110-2109
- Phone
- (405) 732-6821
Authorized Official
- Name
- DR. MARY E MARTIN, DDS
- Title
- CEO VICE PRESIDENT
- Phone
- (405) 732-6821
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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