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General NPI Number Information
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NPI Number | 1790267425
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Entity Type | Organization
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Legal Business Name | ELITE DENTAL CONSULTING, INC.
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Dates
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Enumeration Date | 08/29/2018
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Last Update Date | 08/29/2018
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Provider Practice Location Address
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Address Line | 701 HOWE AVE
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City | SACRAMENTO
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State | CA
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Zip | 95825-4670
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Country | US
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Telephone | 916-483-8182
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Fax |
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Provider Business Mailing Address
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Address Line | 701 HOWE AVE
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City | SACRAMENTO
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State | CA
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Zip | 95825-4670
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Country | US
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Telephone | 916-483-8182
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | JAYSON CHALMERS
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Credential | D.D.S.
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Telephone | 916-508-6444
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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 | 51468
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License Number State | CA
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