# ELITE ENDODONTICS

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

## Provider details

- **NPI number:** 1336654102
- **Authorized official:** DR. DREW WAYNE MOELLER DDS, MS (ENDODONTIST)
- **Authorized official phone:** (616) 502-2846

## Contact information

- **Practice address:** 1135 S LAPEER RD STE A, LAKE ORION, MI 48360-1432
- **Practice address phone:** (616) 502-2846
- **Mailing address:** 6965 OAKHURST RIDGE RD, CLARKSTON, MI 48348-5053

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 2901020373 | MI | Yes |

## Other

- **Enumeration date:** 12/02/2017
- **Last updated:** 12/02/2017