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Organization

ELITE DENTAL ASSOCIATES, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIE HA LUONG (REGIONAL MANAGER)
(214) 909-3764
Entity
Organization

Contact information

Practice address
3023 E INTERSTATE 30, SUITE H, ROCKWALL, TX 75087-9707
(214) 771-3130
(972) 722-0056
Mailing address
3023 E INTERSTATE 30, SUITE H, ROCKWALL, TX 75087-9707
(214) 771-3130
(972) 722-0056

Taxonomy

Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
18994
TX

Other

Enumeration date
05/18/2007
Last updated
08/22/2020
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