MEDICARE: DR. MICHELLE LYNN ELFORD DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	2901013736	MI

General Provider Information

NPI Number	:	1053383521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE LYNN ELFORD DDS

Provider Business Mailing Address
First Line	:	18540 W OUTER DR
Second Line	:	STE 3
City	:	DEARBORN
State	:	MI
Zip	:	48128
Country	:	US
Telephone Number	:	313-562-0100
Fax Number	:	313-562-2041

Provider Business Practice Location Address
First Line	:	18540 W OUTER DR
Second Line	:	STE 3
City	:	DEARBORN
State	:	MI
Zip	:	48128
Country	:	US
Telephone Number	:	313-562-0100
Fax Number	:	313-562-2041

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	07/08/2007

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