Individual
ABIGAIL D ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
380 S HOLLY ST, CANBY, OR 97013-4150
(971) 270-7691
Mailing address
380 S HOLLY ST, CANBY, OR 97013-4150
(971) 270-7691
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H6604
OR
Other
Enumeration date
09/06/2013
Last updated
09/06/2013
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