Dr Phyllis A Odoom, DDS in New London, CT - Dentist

Dr Phyllis A Odoom, DDS is a Dentist - General Practice based in New London, Connecticut. Dr Phyllis A Odoom is licensed to practice in Connecticut (license number 010355) and her current practice location is 1 Shaws Cv, New London, Connecticut. She can be reached at her office (for appointments etc.) via phone at (860) 447-8304.

NPI number for Dr Phyllis A Odoom is 1205063674 and her current mailing address is 635 Main St, Attn: Credentialing Dpt, Middletown, Connecticut. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1205063674.

Contact Information

	Dr Phyllis A Odoom, DDS
	1 Shaws Cv, New London, CT 06320-4902
	(860) 447-8304
	(860) 443-8720

Healthcare Provider's Profile

Full Name	Dr Phyllis A Odoom
Gender	Female
Speciality	Dentist - General Practice
Location	1 Shaws Cv, New London, Connecticut
Accepts Medicare Assignments	Does not participate in Medicare Program. She may not accept medicare assignment.

NPI Data:

NPI Number: 1205063674
Provider Enumeration Date: 06/12/2009
Last Update Date: 01/19/2011

Medical Identifiers

Medical identifiers for Dr Phyllis A Odoom such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1205063674	NPI	-	NPPES
004236354	Medicaid	CT

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223G0001X	Dentist - General Practice	010355 (Connecticut)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Phyllis A Odoom is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Phyllis A Odoom, DDS 635 Main St, Attn: Credentialing Dpt, Middletown, CT 06457-2718 Ph: (860) 347-6971	Dr Phyllis A Odoom, DDS 1 Shaws Cv, New London, CT 06320-4902 Ph: (860) 447-8304

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Dentist in New London, CT

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Dr. Janellen G Matyas, DDS Dentist Medicare: Medicare Enrolled Practice Location: 4 Shaws Cv Ste 202, New London, CT 06320 Phone: 860-443-4199 Fax: 860-444-6145
Dr. Aman Syed, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 21 Montauk Ave, Suite 102, New London, CT 06320 Phone: 860-447-9280 Fax: 860-437-1938

Dr Phyllis A Odoom, DDS - Dentist in New London, CT