Individual
DR. ANDREA ELENBAAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
370 COURTHOUSE RD STE 103, GULFPORT, MS 39507-1889
(228) 203-1700
(228) 203-1770
Mailing address
370 COURTHOUSE RD STE 103, GULFPORT, MS 39507-1889
(228) 203-1700
(228) 203-1770
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2934-96
MS
1223X2210X
Orofacial Pain Dentistry
Primary
2934-96
MS
Other
Enumeration date
03/23/2007
Last updated
11/28/2023
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