Individual
DR. MARK WILLIAM ELICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3223 N BROAD ST, PHILADELPHIA, PA 19140-5007
(215) 707-2890
(215) 707-5885
Mailing address
3223 N BROAD ST, PHILADELPHIA, PA 19140-5007
(215) 707-2890
(215) 707-5885
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D15810
NJ
122300000X
Dentist
Primary
DS043035
PA
Other
Enumeration date
11/16/2005
Last updated
02/24/2023
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