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
1575 N 52ND ST, SUITE 705, PHILADELPHIA, PA 19131-4736
(215) 879-1777
(215) 879-8077
Mailing address
1575 N 52ND ST, SUITE 705, PHILADELPHIA, PA 19131-4736
(215) 879-1777
(215) 879-8077
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
PA
Other
Enumeration date
07/29/2011
Last updated
03/12/2020
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