Organization
ELITE SMILES DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELBEY MAYHEW (CONTROLLER)
(812) 234-7322
Entity
Organization
Contact information
Practice address
1024 LAFAYETTE AVE, TERRE HAUTE, IN 47804-2932
(812) 234-7322
Mailing address
1107 OHIO ST, TERRE HAUTE, IN 47807-3817
(812) 234-7322
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/30/2021
Last updated
06/30/2021
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