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1396759189
ROGER TERRY ELLIS
CLARKSVILLE, TN
NPI
1396759189
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: TN 4003)
Enumeration Date
2006-07-28
Last Update Date
2007-07-08
Business Address
-- ROGER TERRY ELLIS D.D.S.
1718 MEMORIAL DR
CLARKSVILLE, TN 37043-4542
Phone number: 931-552-4935
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Mailing Address
-- ROGER TERRY ELLIS D.D.S.
1718 MEMORIAL DR
CLARKSVILLE, TN 37043-4542
Phone number: 931-552-4935
Copy
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