Individual
STEVEN TRAYCE ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2280 AMERICAN LEGION BLVD, MOUNTAIN HOME, ID 83647-3142
(208) 587-3988
Mailing address
2280 AMERICAN LEGION BLVD, MOUNTAIN HOME, ID 83647-3142
(208) 696-7203
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-5040
ID
Other
Enumeration date
06/03/2019
Last updated
02/19/2020
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