Provider Demographics
NPI:1982722161
Name:MCELFRESH, MONTE GAYLE (DMD)
Entity Type:Individual
Prefix:
First Name:MONTE
Middle Name:GAYLE
Last Name:MCELFRESH
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:PO BOX 241
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:KY
Mailing Address - Zip Code:41006
Mailing Address - Country:US
Mailing Address - Phone:859-472-3395
Mailing Address - Fax:
Practice Address - Street 1:10178 HIGHWAY 27 NORTH
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:KY
Practice Address - Zip Code:41006
Practice Address - Country:US
Practice Address - Phone:859-472-3395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4613122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist