Provider Demographics
NPI:1730255845
Name:ELKIN, STUART (DMD)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:
Last Name:ELKIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3925 W BOYNTON BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-4500
Mailing Address - Country:US
Mailing Address - Phone:561-752-4050
Mailing Address - Fax:561-752-4065
Practice Address - Street 1:3925 W BOYNTON BEACH BLVD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-4500
Practice Address - Country:US
Practice Address - Phone:561-752-4050
Practice Address - Fax:561-752-4065
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL147291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice