Individual
LESLIE ELLINGSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S., M.S.
Contact information
Practice address
1710 N 144TH ST, OMAHA, NE 68154-4715
(402) 496-9733
Mailing address
320 INGLEWOOD CIR, PAPILLION, NE 68133-3366
(402) 719-4858
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
7251
NE
Other
Enumeration date
07/14/2015
Last updated
10/12/2019
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