Elite Smiles Dental, Ltd

NPI #1154781870 in Appleton, Wisconsin

Provider Information

NPI Number: 1154781870
Entity Type: Organization
Organization Name: Elite Smiles Dental, Ltd
Primary Specialty: Dentist - General Practice
Enumeration Date: Feb 24, 2016
Last Updated: Feb 24, 2016

Practice Location

Address: 315 W WISCONSIN AVE
City: Appleton
State: Wisconsin
ZIP Code: 54911-4355
Phone: (920) 731-2211

Authorized Official

Name: DR. ALISSA EDWARDS, D.D.S.
Title: DENTIST
Phone: (920) 731-2211

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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