Robert Mills Elliott, DDS

Individual provider Active NPI General Practice Dentistry · Taos, NM

NPI 1124054358 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1124054358
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
1665 (NM)
Practice address
1090 Goat Springs Road
Taos, NM 87571
Phone
(505) 758-4224
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
1665NMMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1665 NM Yes

Addresses

Primary practice location

1090 Goat Springs Road
Taos, NM 87571

Mailing address

14 Los Cordovas Dr
Ranchos de Taos, NM 87557-8760
Phone (505) 751-3143

Other providers in Taos, NM

All providers in Taos, NM · General Practice Dentistry in New Mexico

Sources for this page

Verify at the official NPI Registry.