Provider Demographics
NPI:1790789410
Name:ELFMAN, JOEL ELLIOTT (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:ELLIOTT
Last Name:ELFMAN
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 1:302 BERLIN RD
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-1413
Mailing Address - Country:US
Mailing Address - Phone:856-429-1900
Mailing Address - Fax:
Practice Address - Street 1:302 BERLIN RD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-1413
Practice Address - Country:US
Practice Address - Phone:856-429-1900
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-09
Last Update Date:2007-07-08
Deactivation Date:2006-03-15
Deactivation Code:
Reactivation Date:2006-03-20
Provider Licenses
StateLicense IDTaxonomies
NJ22DI015206001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics