MEDICARE: DR. TROY NEIL ELMS DDS, MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	16048	TX

General Provider Information

NPI Number	:	1285648527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TROY NEIL ELMS DDS, MS

Provider Business Mailing Address
First Line	:	1501 EMERALD PKWY
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77845-5551
Country	:	US
Telephone Number	:	979-693-6300
Fax Number	:	979-695-9815

Provider Business Practice Location Address
First Line	:	1501 EMERALD PKWY
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77845-5551
Country	:	US
Telephone Number	:	979-693-6300
Fax Number	:	979-695-9815

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2006
Last Update Date	:	07/09/2007

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