| Elite Dental Care Pllc | |
|
6765 Orchard Lake Rd West Bloomfield MI 48322-3422 | |
| (248) 851-6166 | |
| (248) 851-0012 |
| Full Name | Elite Dental Care Pllc |
|---|---|
| Speciality | Dentist |
| Location | 6765 Orchard Lake Rd, West Bloomfield, Michigan |
| Authorized Official Name and Position | Leena M Bahu (OWNER) |
| Authorized Official Contact | 2483187614 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Dental Care Pllc 7189 Woodlore Dr West Bloomfield MI 48323-1387 Ph: (248) 318-7614 | Elite Dental Care Pllc 6765 Orchard Lake Rd West Bloomfield MI 48322-3422 Ph: (248) 851-6166 |
| NPI Number | 1689811788 |
|---|---|
| Provider Enumeration Date | 01/12/2009 |
| Last Update Date | 01/13/2009 |
| Medicare PECOS PAC ID | 7416269766 |
|---|---|
| Medicare Enrollment ID | O20180227000360 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689811788 | NPI | - | NPPES |
| 3299927404 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2901017893 (Michigan) | Primary |
| Provider Name | Leena M Bahu |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1366504631 PECOS PAC ID: 5991023889 Enrollment ID: I20180227000415 |
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