| NPI | 1326051285 |
|---|---|
| Doing Business As | ELLIS DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | RANDAL W ELLIS Dentist/Owner 360-592-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00008470) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2012-05-03 |