Organization
ELITE DENTAL ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE WONG DMD (PRESIDENT)
(814) 571-3806
Entity
Organization
Contact information
Practice address
5815 LIVE OAK ST, SUITE 103, DALLAS, TX 75214-7310
(814) 571-3806
Mailing address
7417 WELLCREST DR, DALLAS, TX 75230-4235
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
26315
TX
Other
Enumeration date
11/10/2015
Last updated
11/10/2015
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