Organization
ELITE ENDODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DREW WAYNE MOELLER DDS, MS (ENDODONTIST)
(616) 502-2846
Entity
Organization
Contact information
Practice address
1135 S LAPEER RD STE A, LAKE ORION, MI 48360-1432
(616) 502-2846
Mailing address
6965 OAKHURST RIDGE RD, CLARKSTON, MI 48348-5053
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
2901020373
MI
Other
Enumeration date
12/02/2017
Last updated
12/02/2017
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