JEREMY W ELLIS

LOGAN, UT
NPI1568558468
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: UT  99-373-9289922)
Enumeration Date2006-10-05
Last Update Date2007-07-08
Business Address
Dr. JEREMY W ELLIS D.D.S.
965 S 100 W #102
LOGAN, UT 84321-6062
Phone number: 435-752-9741
Mailing Address
Dr. JEREMY W ELLIS D.D.S.
965 S 100 W #102
LOGAN, UT 84321-6062
Phone number: 435-752-9741