Provider Demographics
NPI:1144454760
Name:ELZARKA, MONA (DMD)
Entity type:Individual
Prefix:DR
First Name:MONA
Middle Name:
Last Name:ELZARKA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 ROBERTS RD
Mailing Address - Street 2:
Mailing Address - City:CANAAN
Mailing Address - State:NH
Mailing Address - Zip Code:03741-7644
Mailing Address - Country:US
Mailing Address - Phone:603-523-4343
Mailing Address - Fax:
Practice Address - Street 1:18 ROBERTS RD
Practice Address - Street 2:
Practice Address - City:CANAAN
Practice Address - State:NH
Practice Address - Zip Code:03741-7644
Practice Address - Country:US
Practice Address - Phone:603-523-4343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-11
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0105331223G0001X
NH046351223G0001X
VT016.01340051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice