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1790393213
MATTHEW T ELLISON
FORT LIBERTY, NC
NPI
1790393213
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: OR D11258)
Enumeration Date
2020-07-21
Last Update Date
2023-06-13
Business Address
Dr. MATTHEW T ELLISON DDS
WOMACK ARMY MEDICAL CENTER 2817 REILLY ROAD
FORT LIBERTY, NC 28310-0001
Phone number: 910-907-6974
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Mailing Address
Dr. MATTHEW T ELLISON DDS
2828 W AVENUE O4
PALMDALE, CA 93551-3402
Phone number: 661-917-4077
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