| Elite Smiles Dental, Llc | |
|
1024 Lafayette Ave Terre Haute IN 47804-2932 | |
| (812) 234-7322 | |
| Not Available |
| Full Name | Elite Smiles Dental, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1024 Lafayette Ave, Terre Haute, Indiana |
| Authorized Official Name and Position | Shelbey Mayhew (CONTROLLER) |
| Authorized Official Contact | 8122347322 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Smiles Dental, Llc 1107 Ohio St Terre Haute IN 47807-3817 Ph: (812) 234-7322 | Elite Smiles Dental, Llc 1024 Lafayette Ave Terre Haute IN 47804-2932 Ph: (812) 234-7322 |
| NPI Number | 1427628684 |
|---|---|
| Provider Enumeration Date | 06/30/2021 |
| Last Update Date | 06/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427628684 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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