Jack A Elder, DDS

NPI #1164509832 in Benicia, California

Provider Information

NPI Number: 1164509832
Entity Type: Individual
Name: Jack A Elder, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Nov 1, 2006
Last Updated: Jun 3, 2009

Practice Location

Address: 172 EAST D STREET
City: Benicia
State: California
ZIP Code: 94510
Phone: (707) 745-3820

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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