MEDICARE: DR. ELAN SALEE D.M.D.

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	1223G0001X	General Practice Dentistry	DN16209	FL

General Provider Information

NPI Number	:	1609841857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELAN SALEE D.M.D.

Provider Business Mailing Address
First Line	:	12040 S JOG RD
Second Line	:	SUITE 5
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-4164
Country	:	US
Telephone Number	:	561-732-8700
Fax Number	:

Provider Business Practice Location Address
First Line	:	12040 S JOG RD
Second Line	:	SUITE 5
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-4164
Country	:	US
Telephone Number	:	561-732-8700
Fax Number	:

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

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	09/13/2012

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