Organization
DAVID J, ELROD, DMD. A PROFESSIONAL SERVICE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY COLE (PROVIDER RELATIONS MANAGER)
(315) 454-6000
Entity
Organization
Contact information
Practice address
5183 HINKLEVILLE RD, PADUCAH, KY 42001-9667
(270) 415-9006
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9083
KY
Other
Enumeration date
06/28/2012
Last updated
06/28/2012
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