| NPI | 1316359649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA ELENBAAS Owner/Dentist 228-896-1840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 2394-96) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MS 2260-86) |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2014-05-21 |