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
61 W CHELTEN AVE # 63, PHILADELPHIA, PA 19144-2701
(215) 235-4060
Mailing address
61 W CHELTEN AVE # 63, PHILADELPHIA, PA 19144-2701
(215) 235-4060
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS037832
PA
Other
Enumeration date
10/20/2010
Last updated
03/12/2020
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