| NPI | 1679234496 |
|---|---|
| Doing Business As | ELLIS DENTAL |
| Entity Type | Organization |
| Authorized Contact | IHNBAE CHO Dentist 520-906-5765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-01-04 |
| Last Update Date | 2022-01-04 |