# ELITE MOBILE DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083964696
- **Authorized official:** KENDALL BARDIN (REGISTERED AGENT)
- **Authorized official phone:** (214) 769-8995

## Contact information

- **Practice address:** 11706 STRAND ST, DALLAS, TX 75218-1552
- **Practice address phone:** (214) 769-8995
- **Mailing address:** 11706 STRAND ST, DALLAS, TX 75218-1552
- **Mailing address phone:** (214) 769-8995

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | TX | Yes |

## Other

- **Enumeration date:** 09/12/2012
- **Last updated:** 09/12/2012