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General NPI Number Information
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NPI Number | 1871066498
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Entity Type | Organization
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Legal Business Name | ELITE ON BELL
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Dates
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Enumeration Date | 01/07/2019
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Last Update Date | 01/07/2019
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Provider Practice Location Address
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Address Line | 15331 W BELL RD STE 210
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City | SURPRISE
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State | AZ
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Zip | 85374-4104
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Country | US
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Telephone | 623-439-5999
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Fax |
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Provider Business Mailing Address
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Address Line | 15331 W BELL RD STE 210
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City | SURPRISE
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State | AZ
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Zip | 85374-4104
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Country | US
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Telephone | 623-439-5999
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. RUSTIN WRIGHT JONES
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Credential | DDS
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Telephone | 602-448-7890
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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 |
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License Number State |
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