Mark Maher Wadie Elia, DDS
Dentist in Jbsa Lackland, TX. Individual provider (NPI-1).
NPI number1205535366
StatusActive
Last updated in NPPESJun 5, 2024
Details
- NPI
- 1205535366
- Entity type
- Individual (NPI-1)
- Name
- Mark Maher Wadie Elia
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 27, 2023
- Certification date
- May 29, 2024
- Last updated
- Jun 5, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 39858 | TX | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
2133 Klinker StreetBuilding 3352
Jbsa Lackland, TX 78236-5313
Phone 210-292-6258
Mailing address
2133 Klinker StreetBuilding 3352
Jbsa Lackland, TX 78236-5313
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All 40 Dentist providers in Jbsa Lackland · All 672 providers in Jbsa Lackland
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