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1417087719
JEFFREY MARK ELLIS
MEDFORD, NY
NPI
1417087719
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: NY 039551)
Enumeration Date
2007-03-06
Last Update Date
2007-07-08
Business Address
Dr. JEFFREY MARK ELLIS D.D.S., M.S.,C.N.S
3237 ROUTE 112 BLDG 6
MEDFORD, NY 11763-1424
Phone number: 631-698-6934
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Mailing Address
Dr. JEFFREY MARK ELLIS D.D.S., M.S.,C.N.S
3237 ROUTE 112 BLDG 6
MEDFORD, NY 11763-1424
Phone number: 631-698-6934
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