# ELITE DENTAL ASSOCIATES, PA

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

## Provider details

- **NPI number:** 1609084425
- **Authorized official:** JENNIE HA LUONG (REGIONAL MANAGER)
- **Authorized official phone:** (214) 909-3764

## Contact information

- **Practice address:** 3023 E INTERSTATE 30, SUITE H, ROCKWALL, TX 75087-9707
- **Practice address phone:** (214) 771-3130
- **Practice address fax:** (972) 722-0056
- **Mailing address:** 3023 E INTERSTATE 30, SUITE H, ROCKWALL, TX 75087-9707
- **Mailing address phone:** (214) 771-3130
- **Mailing address fax:** (972) 722-0056

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0700X | Prosthodontics | 18994 | TX | Yes |

## Other

- **Enumeration date:** 05/18/2007
- **Last updated:** 08/22/2020