Individual
DR. MICHAEL LEE ELLIOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
220 BROAD, KERNERSVILLE, NC 27284
(336) 996-6551
Mailing address
220 BROAD ST, KERNERSVILLE, NC 27284
(336) 996-6551
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5008
NC
Other
Enumeration date
08/09/2006
Last updated
07/08/2007
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