| Elite Dental | |
|
4323 Lemmon Ave Dallas TX 75219-2706 | |
| (214) 522-4444 | |
| (214) 521-0590 |
| Full Name | Elite Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4323 Lemmon Ave, Dallas, Texas |
| Authorized Official Name and Position | Patrick Moneymaker (OFFICER) |
| Authorized Official Contact | 2145224444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Dental 4323 Lemmon Ave Dallas TX 75219-2706 Ph: (214) 522-4444 | Elite Dental 4323 Lemmon Ave Dallas TX 75219-2706 Ph: (214) 522-4444 |
| NPI Number | 1629301007 |
|---|---|
| Provider Enumeration Date | 09/16/2009 |
| Last Update Date | 09/16/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629301007 | NPI | - | NPPES |
| 1720146129 | Other | TX | DENTIST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 14379 (Texas) | Primary |
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