WAYNE R. ELLIS

BOISE, ID
NPI1427166024
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223E0200X Dentist Endodontics
(Licence: ID  D-1522)
Enumeration Date2006-08-25
Last Update Date2007-07-08
Business Address
DR. WAYNE R. ELLIS D.D.S.
6363 W EMERALD ST BUILDING 102
BOISE, ID 83704-8783
Phone number: 208-376-6307
Mailing Address
DR. WAYNE R. ELLIS D.D.S.
6363 W EMERALD ST BUILDING 102
BOISE, ID 83704-8783
Phone number: 208-376-6307