Organization
ELAINE L. VAN, DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELAINE L VAN DDS (OWNER)
(408) 778-4548
Entity
Organization
Contact information
Practice address
17020 CONDIT RD, #180, MORGAN HILL, CA 95037-7229
(408) 778-4548
(408) 778-4648
Mailing address
17020 CONDIT RD, #180, MORGAN HILL, CA 95037-7229
(408) 778-4548
(408) 778-4648
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
42621
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497801336
DENTI-CAL
CA
Enumeration date
10/29/2014
Last updated
10/29/2014
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