KERISA SUE ELLOWAY

FORTUNA, CA
NPI1154452324
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1223P0221X Dentist, Pediatric Dentistry
(Licence: CA  47254)
Enumeration Date2007-03-08
Last Update Date2007-07-08
Business Address
-- KERISA SUE ELLOWAY D.D.S.
1730 MAIN ST SUITE A
FORTUNA, CA 95540-2451
Phone number: 707-725-1303
Mailing Address
-- KERISA SUE ELLOWAY D.D.S.
1730 MAIN ST STE A
FORTUNA, CA 95540-2451
Phone number: 707-725-1303
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