Individual
DR. JAMES WADE ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1 E BROADWAY, COLUMBIA, MO 65203-4205
(573) 449-2858
Mailing address
2702 BAYONNE CT, COLUMBIA, MO 65203-1407
(573) 445-3194
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
010652
MO
Other
Enumeration date
11/07/2006
Last updated
07/08/2007
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