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General NPI Number Information
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NPI Number | 1790467785
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Entity Type | Organization
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Legal Business Name | ELEVATE DENTAL
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Dates
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Enumeration Date | 08/01/2023
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 2311 HARRY WURZBACH RD
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City | SAN ANTONIO
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State | TX
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Zip | 78209-5543
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Country | US
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Telephone | 210-824-3531
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Fax | 210-824-0068
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Provider Business Mailing Address
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Address Line | 1347 BURNING ARROW
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City | SAN ANTONIO
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State | TX
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Zip | 78258-2765
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Country | US
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Telephone | 617-319-1050
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. EMAD ABDALLAH
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Credential | DMD
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Telephone | 210-824-3531
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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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