Healthcare Provider Details

I. General information

NPI: 1922322072
Provider Name (Legal Business Name): ELLIOT P. SCHLANG DDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2010
Last Update Date: 03/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 WASHINGTON AVE # 312
WHEELING WV
26003-6240
US

IV. Provider business mailing address

33533 W 12 MILE RD SUITE 150
FARMINGTON HILLS MI
48331-3354
US

V. Phone/Fax

Practice location:
  • Phone: 888-833-8441
  • Fax: 888-330-4331
Mailing address:
  • Phone: 888-833-8441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number3884
License Number StateWV

VIII. Authorized Official

Name: ELLIOT P. SCHLANG
Title or Position: DENTAL DIRECTOR
Credential: DDS
Phone: 888-833-8441