| Dental Corporation Of Kelly A. Elward, Dds | |
|
1820 Sonoma Ave Ste 100 Santa Rosa CA 95405-6617 | |
| (707) 539-4646 | |
| (707) 539-3617 |
| Full Name | Dental Corporation Of Kelly A. Elward, Dds |
|---|---|
| Speciality | Dentist |
| Location | 1820 Sonoma Ave Ste 100, Santa Rosa, California |
| Authorized Official Name and Position | Kelly Ann Elward (PRESIDENT) |
| Authorized Official Contact | 7075394646 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Corporation Of Kelly A. Elward, Dds 1820 Sonoma Ave Ste 100 Santa Rosa CA 95405-6617 Ph: (707) 539-4646 | Dental Corporation Of Kelly A. Elward, Dds 1820 Sonoma Ave Ste 100 Santa Rosa CA 95405-6617 Ph: (707) 539-4646 |
| NPI Number | 1467798116 |
|---|---|
| Provider Enumeration Date | 12/28/2012 |
| Last Update Date | 12/28/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467798116 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 42914 (California) | Primary |
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