| Korth B. Elliott, Dds | |
|
8219 Northview St Boise ID 83704-7131 | |
| (208) 378-9280 | |
| Not Available |
| Full Name | Korth B. Elliott, Dds |
|---|---|
| Speciality | Dentist |
| Location | 8219 Northview St, Boise, Idaho |
| Authorized Official Name and Position | Korth B Elliott (OWNER) |
| Authorized Official Contact | 2083789280 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Korth B. Elliott, Dds 8219 Northview St Boise ID 83704-7131 Ph: (208) 378-9280 | Korth B. Elliott, Dds 8219 Northview St Boise ID 83704-7131 Ph: (208) 378-9280 |
| NPI Number | 1679749212 |
|---|---|
| Provider Enumeration Date | 05/04/2008 |
| Last Update Date | 05/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679749212 | NPI | - | NPPES |
| 002652300 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D-1996 (Idaho) | Primary |
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