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1083714885
RICHARD D. ELLSWORTH
LAFAYETTE, IN
NPI
1083714885
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: IN 7107)
Enumeration Date
2006-09-22
Last Update Date
2007-07-08
Business Address
Dr. RICHARD D. ELLSWORTH DDS
150 PROFESSIONAL CT. STE A
LAFAYETTE, IN 47905-5153
Phone number: 765-449-2757
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Mailing Address
Dr. RICHARD D. ELLSWORTH DDS
150 PROFESSIONAL CT. STE A
LAFAYETTE, IN 47905-5153
Phone number: 765-449-2757
Copy
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