NPI 1053547794

Elenbaas & Doty, PLLC

Organisation General Practice Dentistry Gulfport, MS

Practice location

Address: 1924 E Pass Rd, Gulfport, MS 39507-3715
Phone: (228) 896-1840
Fax: (228) 604-4449

Authorised official

Name: Andrea Burger Elenbaas
Title: Owner/Dentist
Phone: (228) 896-1840

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 0293496 (MS)

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Registry record

NPI: 1053547794
Entity type: Organization
NPI issued: 9 Jun 2009
Record last updated: 9 Jun 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.