| NPI | 1144862293 |
|---|---|
| Doing Business As | ELKRIDGE DENTAL |
| Entity Type | Organization |
| Authorized Contact | LYNETTE KRAUSE Insurance Coordinator 307-733-2555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2019-10-10 |