| Elite Dental Group, Pa | |
|
1501 Handley Dr Fort Worth TX 76112-3328 | |
| (817) 451-4141 | |
| (817) 457-4142 |
| Full Name | Elite Dental Group, Pa |
|---|---|
| Speciality | Dentist - Prosthodontics |
| Location | 1501 Handley Dr, Fort Worth, Texas |
| Authorized Official Name and Position | Jennie Ha Luong (REGIONAL MANAGER) |
| Authorized Official Contact | 8174574141 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Dental Group, Pa 1501 Handley Dr Fort Worth TX 76112-3328 Ph: (817) 451-4141 | Elite Dental Group, Pa 1501 Handley Dr Fort Worth TX 76112-3328 Ph: (817) 451-4141 |
| NPI Number | 1972711794 |
|---|---|
| Provider Enumeration Date | 05/18/2007 |
| Last Update Date | 08/17/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972711794 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0700X | Dentist - Prosthodontics | 18994 (Texas) | Primary |
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