Provider Demographics
NPI:1194746164
Name:ELKIND, BRUCE LEE (DDS)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:LEE
Last Name:ELKIND
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 1:9100 BELVEDERE RD 208
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-3609
Mailing Address - Country:US
Mailing Address - Phone:561-798-4077
Mailing Address - Fax:561-798-7889
Practice Address - Street 1:9100 BELVEDERE RD
Practice Address - Street 2:208
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-3607
Practice Address - Country:US
Practice Address - Phone:561-798-4077
Practice Address - Fax:561-798-7889
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2015-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9426122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist