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Organization
RICHARD T. ELLISON, DDS, INC
Active
Organization
RICHARD T. ELLISON, DDS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRI J RICHARDSON (OFFICE MANAGER)
(765) 289-0236
Entity
Organization
Contact information
Practice address
1602 W JACKSON ST, MUNCIE, IN 47303-4962
(765) 289-0236
(765) 289-8569
Mailing address
1602 W JACKSON ST, MUNCIE, IN 47303-4962
(765) 289-0236
(765) 289-8569
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6592
IN
Other
Enumeration date
06/15/2015
Last updated
06/15/2015
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