| NPI | 1114387800 |
|---|---|
| Doing Business As | ELITEMD |
| Doing Business As | SMILEMD |
| Entity Type | Organization |
| Authorized Contact | VASKEYSA COOLEY Credentialing Manager 614-401-4415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 1223D0004X Dentist, Dentist Anesthesiologist Speciality |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2022-04-26 |