Individual
MRS. ELISE ELAINE PRUETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
301 S DENTON TAP RD STE 110, COPPELL, TX 75019-3287
(972) 304-0891
(972) 304-0893
Mailing address
301 S DENTON TAP RD STE 110, COPPELL, TX 75019-3287
(972) 304-0891
(972) 304-0893
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
28899
TX
Other
Enumeration date
11/20/2013
Last updated
07/21/2020
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