# ELITE DENTISTRY

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

## Provider details

- **NPI number:** 1326463506
- **Authorized official:** MRS. PRABH BHUI (OFFICE MANAGER)
- **Authorized official phone:** (360) 253-6375

## Contact information

- **Practice address:** 9300 NE VANCOUVER MALL DR, SUITE \# 100, VANCOUVER, WA 98662-8201
- **Practice address phone:** (360) 253-6375
- **Mailing address:** 9300 NE VANCOUVER MALL DR, SUITE \# 100, VANCOUVER, WA 98662-8201
- **Mailing address phone:** (360) 253-6375

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DE8609 | WA | Yes |

## Other

- **Enumeration date:** 02/25/2014
- **Last updated:** 02/25/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 122300000X | — | WA |