Elite Smiles Dental, Ltd | |
315 W Wisconsin Ave Appleton WI 54911-4355 | |
(920) 731-2211 | |
(920) 733-7176 |
Full Name | Elite Smiles Dental, Ltd |
---|---|
Speciality | Dentist - General Practice |
Location | 315 W Wisconsin Ave, Appleton, Wisconsin |
Authorized Official Name and Position | Alissa Edwards (DENTIST) |
Authorized Official Contact | 9207312211 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Elite Smiles Dental, Ltd 315 W Wisconsin Ave Appleton WI 54911-4355 Ph: (920) 731-2211 | Elite Smiles Dental, Ltd 315 W Wisconsin Ave Appleton WI 54911-4355 Ph: (920) 731-2211 |
NPI Number | 1154781870 |
---|---|
Provider Enumeration Date | 02/24/2016 |
Last Update Date | 02/24/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154781870 | NPI | - | NPPES |
1578874426 | Other | WI | NPI TYPE 1 |
6542-15 | Other | WI | LICENSE NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 6542-15 (Wisconsin) | Primary |
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