Organization
ELITE PRACTICE MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY AVANT (PRACTICE MANAGER)
(662) 314-3585
Entity
Organization
Contact information
Practice address
7185 CRAPE MYRTLE DR, OLIVE BRANCH, MS 38654-1971
(662) 314-3585
(662) 346-5438
Mailing address
7185 CRAPE MYRTLE DR, OLIVE BRANCH, MS 38654-1971
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
08/18/2020
Last updated
08/18/2020
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