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1003314535
EVAN BALE ELLSWORTH
HENDERSON, NV
NPI
1003314535
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: NV 7010)
Enumeration Date
2018-01-30
Last Update Date
2019-03-17
Business Address
Dr. EVAN BALE ELLSWORTH DMD
2660 WINDMILL PKWY
HENDERSON, NV 89074-3385
Phone number: 702-990-2960
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Mailing Address
Dr. EVAN BALE ELLSWORTH DMD
6127 S RAINBOW BLVD STE 100
LAS VEGAS, NV 89118-3256
Phone number: 702-793-2182
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