TY ELLSWORTH

SHOW LOW, AZ
NPI1699124123
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: AZ  D009461)
Enumeration Date2016-06-06
Last Update Date2021-06-28
Business Address
TY ELLSWORTH DMD
2650 E SHOW LOW LAKE RD STE 1
SHOW LOW, AZ 85901-7955
Phone number: 928-537-4300
Mailing Address
TY ELLSWORTH DMD
PO BOX 3630
FLAGSTAFF, AZ 86003-3630
Phone number: 928-522-9879
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