| NPI | 1063183044 |
|---|---|
| Doing Business As | ELITE DENTAL STUDIO |
| Entity Type | Organization |
| Authorized Contact | STEPHANIE MOORE Director Of Revenue Cycle 832-704-4262 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 1223E0200X Dentist Endodontics |
| 1223P0221X Dentist Pediatric Dentistry | |
| 1223P0300X Dentist Periodontics | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2021-09-21 |
| Last Update Date | 2024-07-26 |