| NPI | 1861091720 |
|---|---|
| Doing Business As | DR. ELLEN IM PEDIATRIC DENTISTRY AND ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | ELLEN IM Owner/Operator 858-679-6660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2021-05-06 |