| M Elder Dental Group Corporation | |
|
704 Blossom Hill Rd Ste 102 San Jose CA 95123-5403 | |
| (408) 225-5000 | |
| Not Available |
| Full Name | M Elder Dental Group Corporation |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 704 Blossom Hill Rd Ste 102, San Jose, California |
| Authorized Official Name and Position | Emmy Montes (DIRECTOR OF CENTRALIZED BILLING) |
| Authorized Official Contact | 4152466305 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| M Elder Dental Group Corporation 446 Merlot Ln American Canyon CA 94503-1243 Ph: () - | M Elder Dental Group Corporation 704 Blossom Hill Rd Ste 102 San Jose CA 95123-5403 Ph: (408) 225-5000 |
| NPI Number | 1215599394 |
|---|---|
| Provider Enumeration Date | 06/28/2019 |
| Last Update Date | 06/28/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215599394 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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