Individual
JESSE ELLSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
126 E DIVISION RD, OAK RIDGE, TN 37830-6906
(865) 481-0008
(865) 481-0695
Mailing address
1018 GARRISON RIDGE BLVD, KNOXVILLE, TN 37922-5155
(801) 598-2774
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS10287
TN
Other
Enumeration date
07/06/2016
Last updated
08/30/2022
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