# ELITE DENTAL CARE, PLLC

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

## Provider details

- **NPI number:** 1851449003
- **Authorized official:** DR. J. JEFFREY YBARGUEN D.D.S. (OWNER)
- **Authorized official phone:** (208) 542-9900

## Contact information

- **Practice address:** 3423 MERLIN DR, SUITE 100, IDAHO FALLS, ID 83404-7430
- **Practice address phone:** (208) 542-9900
- **Practice address fax:** (208) 523-4182
- **Mailing address:** 3423 MERLIN DR, SUITE 100, IDAHO FALLS, ID 83404-7430
- **Mailing address phone:** (208) 542-9900
- **Mailing address fax:** (208) 523-4182

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | D-3536 | ID | Yes |

## Other

- **Enumeration date:** 01/06/2007
- **Last updated:** 09/01/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 806047500 | — | ID |