Provider Demographics
NPI:1225123003
Name:O'DONNELL DENTAL CORPORATION
Entity Type:Organization
Organization Name:O'DONNELL DENTAL CORPORATION
Other - Org Name:FOLSOM HILLS DENTISTRY DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DDS
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:O'DONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-984-9600
Mailing Address - Street 1:17000 RED HILL AVE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-5626
Mailing Address - Country:US
Mailing Address - Phone:714-845-8890
Mailing Address - Fax:949-474-1495
Practice Address - Street 1:2465 IRON POINT RD
Practice Address - Street 2:STE. 120
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-8710
Practice Address - Country:US
Practice Address - Phone:916-984-9600
Practice Address - Fax:916-984-9076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty