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Organization
ELAN LAKE LANSING
Active
Organization
ELAN LAKE LANSING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAURICIO MOELLER DDS, MS (MBR)
(734) 276-2541
Entity
Organization
Contact information
Practice address
818 W LAKE LANSING RD, EAST LANSING, MI 48823-1308
(517) 333-9500
Mailing address
818 W LAKE LANSING RD, EAST LANSING, MI 48823-1308
(517) 333-9500
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
18235
MI
Other
Enumeration date
06/26/2018
Last updated
06/26/2018
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