Provider Demographics
NPI:1851775621
Name:ELITE FAMILY DENTAL CARE
Entity Type:Organization
Organization Name:ELITE FAMILY DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELKAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LINN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:856-784-4788
Mailing Address - Street 1:103 N WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:LAUREL SPRINGS
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-1648
Mailing Address - Country:US
Mailing Address - Phone:856-784-4788
Mailing Address - Fax:856-784-3017
Practice Address - Street 1:103 N WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:LAUREL SPRINGS
Practice Address - State:NJ
Practice Address - Zip Code:08021-1648
Practice Address - Country:US
Practice Address - Phone:856-784-4788
Practice Address - Fax:856-784-3017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-11
Last Update Date:2015-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02010100261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental