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General NPI Number Information
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NPI Number | 1629326319
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Entity Type | Individual
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Provider Name | NANA ODOOM DDS
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Gender | Female
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Dates
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Enumeration Date | 08/28/2012
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Last Update Date | 11/03/2021
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Provider Practice Location Address
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Address Line | 200 BENT CREEK BLVD STE 3
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City | MECHANICSBURG
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State | PA
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Zip | 17050-1938
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Country | US
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Telephone | 717-589-4500
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Fax | 717-207-7060
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Provider Business Mailing Address
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Address Line | 417 OLD FARM LN STE B-3A
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City | MECHANICSBURG
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State | PA
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Zip | 17050-4117
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Country | US
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Telephone | 571-225-7921
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DS039358
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License Number State | PA
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