SHANE L ELLSWORTH

MCMINNVILLE, OR
NPI1639379522
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: OR  d9517)
Enumeration Date2007-07-19
Last Update Date2011-01-06
Business Address
Dr. SHANE L ELLSWORTH DMD
704 NE EVANS ST
MCMINNVILLE, OR 97128-3926
Phone number: 503-472-1404
Mailing Address
Dr. SHANE L ELLSWORTH DMD
704 NE EVANS ST
MCMINNVILLE, OR 97128-3926
Phone number: 503-472-1402
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