| Elan Dental Group | |
|
1500 Abbott Rd Ste 120 East Lansing MI 48823-1956 | |
| (517) 351-9540 | |
| (517) 351-1645 |
| Full Name | Elan Dental Group |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1500 Abbott Rd Ste 120, East Lansing, Michigan |
| Authorized Official Name and Position | Sergio Mauricio Moeller Zevallos (DENTIST) |
| Authorized Official Contact | 7346627874 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elan Dental Group 2509 S State St Ann Arbor MI 48104-6145 Ph: (734) 662-7874 | Elan Dental Group 1500 Abbott Rd Ste 120 East Lansing MI 48823-1956 Ph: (517) 351-9540 |
| NPI Number | 1427595164 |
|---|---|
| Provider Enumeration Date | 01/19/2017 |
| Last Update Date | 01/19/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427595164 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 18235 (Michigan) | Primary |
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