Organization
ELITE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHIL KURAL (DIRECTOR DOCTOR CREDENTIALING)
(312) 274-4526
Entity
Organization
Contact information
Practice address
5597 TULIP ST STE B4, PHILADELPHIA, PA 19124-1562
(215) 288-8008
Mailing address
350 N CLARK ST STE 600, CHICAGO, IL 60654-4782
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/29/2018
Last updated
03/12/2020
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