Wittbold, Elsa Marie
Wittbold, Elsa Marie is an individual health care provider with primary practice located at 555 W Granada Blvd Suite C-2, Ormond Beach FL 32174-9485. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Wittbold, Elsa Marie can be contacted via phone (386) 675-6769.Contact Information
Primary practice address
555 W Granada Blvd Suite C-2
Ormond Beach FL 32174-9485
Phone: (386) 675-6769
Fax: (386) 657-6770
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | DN 18198 | Florida |
Profile Details
| NPI number | 1851598593 |
|---|---|
| LBN Legal business name | Wittbold, Elsa Marie |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 27th, 2007 |
| Last updated | Nov 15th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851598593 | NPPES |
| Hawaii | Other | DT-1511 | DENTTAL LICENSE |
| Hawaii | Other | DN18198 | DENTTAL LICENSE |
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