| NPI | 1518747765 |
|---|---|
| Doing Business As | ELITE DENTAL GROUP CANON CITY |
| Entity Type | Organization |
| Authorized Contact | KYU HYUK JUNG President/Dentist 719-275-5933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-10-04 |
| Last Update Date | 2023-11-15 |