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General NPI Number Information
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NPI Number | 1558140657
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Entity Type | Organization
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Legal Business Name | CHARLES ELWELL III, D.M.D., P.A.
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Dates
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Enumeration Date | 09/27/2023
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 3307 CLARK RD STE 104
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City | SARASOTA
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State | FL
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Zip | 34231-8419
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Country | US
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Telephone | 941-366-8882
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Fax |
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Provider Business Mailing Address
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Address Line | 3307 CLARK RD STE 104
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City | SARASOTA
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State | FL
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Zip | 34231-8419
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Country | US
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Telephone | 941-366-8882
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. CHARLES W ELWELL III
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Credential | D.M.D.
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Telephone | 941-366-8882
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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 |
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License Number State |
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