Organization
ELITEDENT PB
Active
Other names
EliteDent PB
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACQUELINE CORREA (PRESIDENT)
(786) 351-5050
Entity
Organization
Contact information
Practice address
16935 S DIXIE HWY, PALMETTO BAY, FL 33157-4361
(305) 646-6700
Mailing address
16935 S DIXIE HWY, PALMETTO BAY, FL 33157-4361
(305) 646-6700
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/07/2024
Last updated
10/07/2024
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