Provider Demographics
NPI:1881994184
Name:EHLAND, ELISE LOUISE (DDS)
Entity type:Individual
Prefix:DR
First Name:ELISE
Middle Name:LOUISE
Last Name:EHLAND
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 FLORIDA AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-2715
Mailing Address - Country:US
Mailing Address - Phone:504-889-9893
Mailing Address - Fax:
Practice Address - Street 1:1100 FLORIDA AVE FL 2
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-2715
Practice Address - Country:US
Practice Address - Phone:504-889-9893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-02
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA75831223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty