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General NPI Number Information
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NPI Number | 1194187534
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Entity Type | Organization
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Legal Business Name | MARVO C. ODDS, DDS, P.C.
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Dates
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Enumeration Date | 03/24/2016
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Last Update Date | 03/24/2016
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Provider Practice Location Address
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Address Line | 1872 N MAIN ST
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City | SHELBYVILLE
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State | TN
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Zip | 37160-2018
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Country | US
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Telephone | 931-680-9460
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Fax |
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Provider Business Mailing Address
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Address Line | 1872 N MAIN ST
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City | SHELBYVILLE
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State | TN
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Zip | 37160-2018
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Country | US
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Telephone | 931-680-9460
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Fax |
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Authorized Official
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Title or Position | DDS/PRACTICE OWNER
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Name | MARVO ODDS
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Credential |
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Telephone | 931-680-9460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7854
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License Number State | TN
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