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General NPI Number Information
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NPI Number | 1699000349
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Entity Type | Individual
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Provider Name | ELIZABETH BAUER HITE DMD MS
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Gender | Female
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Dates
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Enumeration Date | 10/14/2009
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Last Update Date | 10/14/2009
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Provider Practice Location Address
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Address Line | 23 GLEN ED PROFESSIONAL PARK
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City | GLEN CARBON
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State | IL
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Zip | 62034-3333
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Country | US
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Telephone | 618-692-1044
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Fax | 618-692-6809
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Provider Business Mailing Address
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Address Line | 23 GLEN ED PROFESSIONAL PARK
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City | GLEN CARBON
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State | IL
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Zip | 62034-3333
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Country | US
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Telephone | 618-692-1044
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Fax | 618-692-6809
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 019027524
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License Number State | IL
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