Kevin M Elliott

NPI #1184852758 in Mccall, Idaho

Provider Information

NPI Number: 1184852758
Entity Type: Organization
Organization Name: Kevin M Elliott
Primary Specialty: Dentist
Enumeration Date: Jun 23, 2009
Last Updated: Jun 23, 2009

Practice Location

Address: 327 DEINHARD LN
City: Mccall
State: Idaho
ZIP Code: 83638-4703
Phone: (208) 634-1214

Authorized Official

Name: DR. KEVIN MICHAEL ELLIOTT
Title: D.M.D.
Phone: (208) 634-1214

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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