David F Elliott, DMD

Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Jackson, NJ

NPI 1962653592 · NPPES record last updated Oct 1, 2008

Key facts

NPI
1962653592
Entity type
Individual (NPI type 1)
Primary specialty
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
License
22DIO1652800 (NJ)
Practice address
10 S New Prospect Rd
Suite 23
Jackson, NJ 08527-1645
Phone
(732) 364-3322
Fax
(732) 364-7922
NPI assigned
Oct 1, 2008
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
22DIO1652800NJMDOrthodontics and Dentofacial Orthopedic Dentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 22DIO1652800 NJ Yes

Addresses

Primary practice location

10 S New Prospect Rd
Suite 23
Jackson, NJ 08527-1645

Mailing address

10 S New Prospect Rd
Suite 23
Jackson, NJ 08527-1645
Phone (732) 364-3322

Other providers in Jackson, NJ

All providers in Jackson, NJ · Orthodontics and Dentofacial Orthopedics Dentistry in New Jersey

Sources for this page

Verify at the official NPI Registry.