Individual
DR. THEODIS ELZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
705 WINDY HILL RD SE, SMYRNA, GA 30080-1854
(770) 801-1641
(770) 801-0587
Mailing address
705 WINDY HILL RD SE, SMYRNA, GA 30080-1854
(770) 801-1641
(770) 801-0587
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
010679
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00867908A
—
GA
Enumeration date
07/18/2006
Last updated
07/08/2007
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