# ELLIS ENDODONTICS, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285108563
- **Authorized official:** DR. GREGORY BRANT ELLIS DDS, MSCD (DOCTOR-OWNER)
- **Authorized official phone:** (832) 452-3169

## Contact information

- **Practice address:** 303 LONGMIRE RD UNIT 901, CONROE, TX 77304-2101
- **Practice address phone:** (936) 760-2222
- **Practice address fax:** (936) 760-2233
- **Mailing address:** 303 LONGMIRE RD UNIT 901, CONROE, TX 77304-2101
- **Mailing address phone:** (936) 760-2222
- **Mailing address fax:** (936) 760-2233

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | — | — | Yes |

## Other

- **Enumeration date:** 01/19/2019
- **Last updated:** 01/19/2019