| NPI | 1356076152 |
|---|---|
| Doing Business As | ELITE DENTAL CARE JACKSON |
| Entity Type | Organization |
| Authorized Contact | TOM LANNOM Chief Operating Officer 731-855-1053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-07-18 |
| Last Update Date | 2022-07-18 |