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Organization

JOHN T. ELI, D.M.D., M.S.D., INC.

Active
Other names
Eli Orthodontics
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN T ELI D.M.D., M.S.D. (ORTHODONTIST)
(949) 855-8480
Entity
Organization

Contact information

Practice address
21791 LAKE FOREST DR, SUITE 204, LAKE FOREST, CA 92630-2760
(949) 855-8480
Mailing address
21791 LAKE FOREST DR, SUITE 204, LAKE FOREST, CA 92630-2760
(949) 855-8480

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
52381
CA

Other

Enumeration date
10/29/2007
Last updated
10/29/2007
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