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DR. CHRISTINE GUTIERREZ ELAM DMD

Pediatric Dentistry >> Dentist >> Dental Providers

Registrant NPI Number: 1922136092

Individual Registrant:
DR. CHRISTINE GUTIERREZ ELAM DMD
Gender: F
Not Sole Proprietor

Location and contact information for practice:
66 W MAIN ST  BRONSON, FL 32621-6338 US
Tel: 352-486-5300  Fax: 352-486-5307

Contact information for business:
66 W MAIN ST  BRONSON, FL 32621-6338 US
Tel: 352-486-5300  Fax: 352-486-5307

Registration Information:
NPI: 1922136092
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N1223P0221XDental Providers
Dentist
Pediatric Dentistry
FLDN 15416
Y1223G0001XDental Providers
Dentist
FLDN15416

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
DEABG 7022863FL01
075720900FL05




HEALTH CARE JOBS FL - Page 1



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