Individual
OLIN ANDREW ELLIOTT II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
196 KY HWY 3188, MARTIN, KY 41649
(606) 285-9317
(606) 285-4842
Mailing address
PO BOX 1381, 196 KY HWY 3188, MARTIN, KY 41649
(606) 285-9317
(606) 285-4842
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5605
KY
1223G0001X
General Practice Dentistry
5605
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60056058
—
KY
Enumeration date
01/29/2007
Last updated
06/02/2016
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