Individual
DR. HEIDI SUSAN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
NAVAL POSTGRADUATE SCHOOL, 8901 WISCONSIN AVE, BETHESDA, MD 20889-5602
(301) 295-0145
Mailing address
NAVAL POSTGRADUATE SCHOOL, 8901 WISCONSIN AVE, BETHESDA, MD 20889-5602
(301) 295-0145
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901018715
MI
Other
Enumeration date
12/09/2005
Last updated
08/05/2013
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