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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851598593 NPPES
Hawaii Other DT-1511 DENTTAL LICENSE
Hawaii Other DN18198 DENTTAL LICENSE

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