| Elite Practice Management | |
|
7185 Crape Myrtle Dr Olive Branch MS 38654-1971 | |
| (662) 314-3585 | |
| (662) 346-5438 |
| Full Name | Elite Practice Management |
|---|---|
| Speciality | Dentist |
| Location | 7185 Crape Myrtle Dr, Olive Branch, Mississippi |
| Authorized Official Name and Position | Kimberly Avant (PRACTICE MANAGER) |
| Authorized Official Contact | 6623143585 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Practice Management 7185 Crape Myrtle Dr Olive Branch MS 38654-1971 | Elite Practice Management 7185 Crape Myrtle Dr Olive Branch MS 38654-1971 Ph: (662) 314-3585 |
| NPI Number | 1124630462 |
|---|---|
| Provider Enumeration Date | 08/18/2020 |
| Last Update Date | 08/18/2020 |
| Certification Date | 08/18/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124630462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | () | Primary |
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