Organization
KEVIN M ELLIOTT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN MICHAEL ELLIOTT (D.M.D.)
(208) 634-1214
Entity
Organization
Contact information
Practice address
327 DEINHARD LN, MCCALL, ID 83638-4703
(208) 634-1214
Mailing address
PO BOX 990, MCCALL, ID 83638-0990
(208) 634-1214
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D3826
ID
Other
Enumeration date
06/23/2009
Last updated
06/23/2009
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