Provider Demographics
NPI:1578654364
Name:LINN, ELKAN ENPEI (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELKAN
Middle Name:ENPEI
Last Name:LINN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 NORTH WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:LAUREL SPRINGS
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-1648
Mailing Address - Country:US
Mailing Address - Phone:856-784-4788
Mailing Address - Fax:856-784-3017
Practice Address - Street 1:103 NORTH WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:LAUREL SPRINGS
Practice Address - State:NJ
Practice Address - Zip Code:08021-1648
Practice Address - Country:US
Practice Address - Phone:856-784-4788
Practice Address - Fax:856-784-3017
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI020101001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice