| Joseph H. Elison And/or Joseph Matthew Elison | |
|
3357 Merlin Dr Idaho Falls ID 83404-7405 | |
| (208) 522-9600 | |
| (208) 522-9799 |
| Full Name | Joseph H. Elison And/or Joseph Matthew Elison |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 3357 Merlin Dr, Idaho Falls, Idaho |
| Authorized Official Name and Position | Joseph H. Elison (ORTHODONTIST) |
| Authorized Official Contact | 2085229600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Joseph H. Elison And/or Joseph Matthew Elison 3357 Merlin Dr Idaho Falls ID 83404-7405 Ph: (208) 522-9600 | Joseph H. Elison And/or Joseph Matthew Elison 3357 Merlin Dr Idaho Falls ID 83404-7405 Ph: (208) 522-9600 |
| NPI Number | 1740215870 |
|---|---|
| Provider Enumeration Date | 07/11/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740215870 | NPI | - | NPPES |
| 000010012467 | Other | ID | BLUE SHIELD OF IDAHO |
| 1634056 | Other | ID | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | D1702 OR (Idaho) | Primary |
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