Organization
ELISON ORTHODONTICS PLLC
Active
Other names
Joseph H. Elison and/or Joseph Matthew Elison
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH H. ELISON D.D.S.,M.S. (ORTHODONTIST)
(208) 522-9600
Entity
Organization
Contact information
Practice address
3357 MERLIN DR, IDAHO FALLS, ID 83404-7405
(208) 522-9600
(208) 522-9799
Mailing address
3357 MERLIN DR, IDAHO FALLS, ID 83404-7405
(208) 522-9600
(208) 522-9799
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D1702 OR
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010012467
BLUE SHIELD OF IDAHO
ID
01
—
1634056
UNITED CONCORDIA
ID
Enumeration date
07/11/2006
Last updated
08/22/2020
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