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General NPI Number Information
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NPI Number | 1326690264
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Entity Type | Organization
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Legal Business Name | SCOTT ELSEY DDS PLLC
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Dates
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Enumeration Date | 07/11/2019
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Last Update Date | 07/11/2019
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Provider Practice Location Address
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Address Line | 205 E MAIN ST
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City | PICKFORD
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State | MI
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Zip | 49774-8936
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Country | US
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Telephone | 906-647-9201
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 308
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City | PICKFORD
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State | MI
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Zip | 49774-0308
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Country | US
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Telephone | 586-339-5083
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Fax |
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Authorized Official
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Title or Position | SOLE OWNER
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Name | DR. SCOTT PATRICK ELSEY
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Credential | DDS
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Telephone | 586-339-5083
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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