Individual
LISA ELIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MSD
Contact information
Practice address
320 MCKENZIE AVE STE 207, COUNCIL BLUFFS, IA 51503-1002
(712) 256-9943
Mailing address
4217 SUNSET DR W, UNIVERSITY PLACE, WA 98466-2408
(989) 928-7473
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
09979
IA
1223E0200X
Endodontics
60846271
WA
Other
Enumeration date
03/17/2013
Last updated
11/06/2023
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