Individual
DR. EDIOUS K. ELLIOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
8240 CAZENOVIA RD STE 60, MANLIUS, NY 13104-8814
(315) 692-6546
(315) 692-0449
Mailing address
8240 CAZENOVIA RD STE 60, MANLIUS, NY 13104-8814
(315) 692-6546
(315) 692-0449
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
22DI02507400
NJ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS040658
PA
207L00000X
Anesthesiology Physician
DA031767
PA
Other
Enumeration date
07/05/2012
Last updated
07/06/2021
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