# ELKINS DENTISTRY, PLLC

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

## Provider details

- **NPI number:** 1699051250
- **Authorized official:** CLARK ELKINS D.M.D. (PRESIDENT)
- **Authorized official phone:** (208) 369-4532

## Contact information

- **Practice address:** 1110 S WASHINGTON AVE, EMMETT, ID 83617-3535
- **Practice address phone:** (208) 369-4532
- **Mailing address:** 1110 S WASHINGTON AVE, EMMETT, ID 83617-3535

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D-3922 | ID | Yes |

## Other

- **Enumeration date:** 10/27/2011
- **Last updated:** 03/28/2012