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Organization

ELEY FAMILY DENTISTRY, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DANIEL WARREN ELEY D.M.D. (PRESIDENT)
(321) 622-8711
Entity
Organization

Contact information

Practice address
2301 W EAU GALLIE BLVD, SUITE #102, MELBOURNE, FL 32935-3120
(321) 622-8711
(321) 622-8712
Mailing address
2301 W EAU GALLIE BLVD, SUITE #102, MELBOURNE, FL 32935-3120
(321) 622-8711
(321) 622-8712

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN19369
FL
1223P0221X
Pediatric Dentistry
DN22269
GA

Other

Enumeration date
04/17/2014
Last updated
09/13/2016
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