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Individual
DR. ELLIS BURKE JARDINE
Active
Individual
DR. ELLIS BURKE JARDINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
7240
AZ
1223P0700X
Prosthodontics
27917
TX
1223P0700X
Prosthodontics
9441
TN
1223P0700X
Prosthodontics
DE 60339865
WA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DE60339865
WA
Other
Enumeration date
06/27/2007
Last updated
03/07/2023
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