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General NPI Number Information
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NPI Number | 1902524200
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Entity Type | Individual
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Provider Name | ELISE TIGANI ENDRES DDS
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Gender | Female
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Dates
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Enumeration Date | 08/22/2022
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Last Update Date | 08/22/2022
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Provider Practice Location Address
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Address Line | 3905 NATIONAL DR STE 170
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City | BURTONSVILLE
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State | MD
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Zip | 20866-6102
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Country | US
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Telephone | 301-989-0088
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Fax |
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Provider Business Mailing Address
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Address Line | 3802 LELAND ST
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City | CHEVY CHASE
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State | MD
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Zip | 20815-4902
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Country | US
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Telephone |
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Fax |
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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 | 16806
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License Number State | MD
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