DR. Kevin Michael Elliott, DMD

NPI #1104910199 in Cascade, Idaho

Provider Information

NPI Number: 1104910199
Entity Type: Individual
Name: DR. Kevin Michael Elliott, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DMD
Enumeration Date: Oct 3, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 220 S MAIN ST
City: Cascade
State: Idaho
ZIP Code: 86311
Phone: (208) 382-3558

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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