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Individual
DR. ELLIE N/A BASH
Active
Individual
DR. ELLIE N/A BASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
11391
NC
1223P0300X
Periodontics
Primary
11391
NC
Other
Enumeration date
06/16/2019
Last updated
10/18/2022
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