| Basin Dental Suite Pllc | |
|
631 E 42nd Street Odessa TX 79762-7721 | |
| (432) 260-9636 | |
| Not Available |
| Full Name | Basin Dental Suite Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 631 E 42nd Street, Odessa, Texas |
| Authorized Official Name and Position | Ayotunde Oluyomi Esho (DOCTOR) |
| Authorized Official Contact | 4407150146 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Basin Dental Suite Pllc 1403 San Miguel Ct Midland TX 79705-2253 Ph: (440) 715-0146 | Basin Dental Suite Pllc 631 E 42nd Street Odessa TX 79762-7721 Ph: (432) 260-9636 |
| NPI Number | 1952974461 |
|---|---|
| Provider Enumeration Date | 07/22/2021 |
| Last Update Date | 12/29/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952974461 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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