# DAVID J, ELROD, DMD. A PROFESSIONAL SERVICE CORPORATION

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

## Provider details

- **NPI number:** 1285998815
- **Authorized official:** ASHLEY COLE (PROVIDER RELATIONS MANAGER)
- **Authorized official phone:** (315) 454-6000

## Contact information

- **Practice address:** 5183 HINKLEVILLE RD, PADUCAH, KY 42001-9667
- **Practice address phone:** (270) 415-9006
- **Mailing address:** PO BOX 3189, SYRACUSE, NY 13220-3189

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 9083 | KY | Yes |

## Other

- **Enumeration date:** 06/28/2012
- **Last updated:** 06/28/2012