Provider Demographics
NPI:1396899118
Name:ELEDENT, INC. PA
Entity type:Organization
Organization Name:ELEDENT, INC. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:ELEFANT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:561-502-4366
Mailing Address - Street 1:801 SE 6TH AVE
Mailing Address - Street 2:SUITE #101
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5185
Mailing Address - Country:US
Mailing Address - Phone:561-278-8218
Mailing Address - Fax:561-278-8291
Practice Address - Street 1:801 SE 6TH AVE
Practice Address - Street 2:SUITE #105
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5185
Practice Address - Country:US
Practice Address - Phone:561-272-2424
Practice Address - Fax:561-272-0232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental