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1568558468
JEREMY W ELLIS
LOGAN, UT
NPI
1568558468
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: UT 99-373-9289922)
Enumeration Date
2006-10-05
Last Update Date
2007-07-08
Business Address
Dr. JEREMY W ELLIS D.D.S.
965 S 100 W #102
LOGAN, UT 84321-6062
Phone number: 435-752-9741
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Mailing Address
Dr. JEREMY W ELLIS D.D.S.
965 S 100 W #102
LOGAN, UT 84321-6062
Phone number: 435-752-9741
Copy
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