# KORTH B. ELLIOTT, DDS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679749212
- **Authorized official:** KORTH B ELLIOTT DDS (OWNER)
- **Authorized official phone:** (208) 378-9280

## Contact information

- **Practice address:** 8219 NORTHVIEW ST, BOISE, ID 83704-7131
- **Practice address phone:** (208) 378-9280
- **Mailing address:** 8219 NORTHVIEW ST, BOISE, ID 83704-7131
- **Mailing address phone:** (208) 378-9280

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | D-1996 | ID | Yes |

## Other

- **Enumeration date:** 05/04/2008
- **Last updated:** 05/04/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 002652300 | — | ID |