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General NPI Number Information
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NPI Number | 1275805244
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Entity Type | Organization
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Legal Business Name | NATALIA ELSON,DDS,PC
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Dates
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Enumeration Date | 02/06/2012
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Last Update Date | 02/06/2012
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Provider Practice Location Address
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Address Line | 150 ISLIP AVE STE 5
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City | ISLIP
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State | NY
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Zip | 11751-3222
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Country | US
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Telephone | 631-525-3827
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Fax | 631-514-2468
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Provider Business Mailing Address
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Address Line | 150 ISLIP AVE STE 5
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City | ISLIP
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State | NY
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Zip | 11751-3222
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. NATALIA ELSON
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Credential | DDS
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Telephone | 631-525-3827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 055703
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License Number State | NY
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