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1003968983
MICHAEL ROY ELLIS
BRISTOL, CT
NPI
1003968983
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: CT 007856)
Enumeration Date
2007-01-18
Last Update Date
2007-07-08
Business Address
Dr. MICHAEL ROY ELLIS DMD
789 FARMINGTON AVE
BRISTOL, CT 06010-3919
Phone number: 860-583-6056
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Mailing Address
Dr. MICHAEL ROY ELLIS DMD
789 FARMINGTON AVE
BRISTOL, CT 06010-3919
Phone number: 860-583-6056
Copy
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