Provider Demographics
NPI:1609841857
Name:SALEE, ELAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:ELAN
Middle Name:
Last Name:SALEE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12040 S JOG RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-4164
Mailing Address - Country:US
Mailing Address - Phone:561-732-8700
Mailing Address - Fax:
Practice Address - Street 1:12040 S JOG RD
Practice Address - Street 2:SUITE 5
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-4164
Practice Address - Country:US
Practice Address - Phone:561-732-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN162091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice