| Organization Name: | LIZZIE O'DELL PLLC |
| NPI Number: | 1073987038 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ELIZABETH PHAM O'DELL (OWNER) |
| Mailing Address: | 3520 Teays Valley Rd Hurricane |
| State: | WV US |
| Postal Code: | 255269479 |
| Phone Number: | 3345381390 |
| Fax Number: | |
| NPI Enumeration Date: | 11/13/2015 |
| NPI Last Update Date: | 11/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223P0221X |
| License Number: | 4042 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Dentist |
| Taxonomy Specialization: | Pediatric Dentistry |
| Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |