MEDICARE: DR. STUART ELKIN D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	14729	FL

General Provider Information

NPI Number	:	1730255845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STUART ELKIN D.M.D.

Provider Business Mailing Address
First Line	:	3925 W BOYNTON BEACH BLVD
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-4500
Country	:	US
Telephone Number	:	561-752-4050
Fax Number	:	561-752-4065

Provider Business Practice Location Address
First Line	:	3925 W BOYNTON BEACH BLVD
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-4500
Country	:	US
Telephone Number	:	561-752-4050
Fax Number	:	561-752-4065

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	07/08/2007

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