Individual
DR. JEROME C ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
230 N EASTOWN RD, LIMA, OH 45807-2211
(419) 228-2233
(419) 228-8152
Mailing address
230 N EASTOWN RD, LIMA, OH 45807-2211
(419) 228-2233
(419) 228-8152
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30023234
OH
Other
Enumeration date
06/25/2010
Last updated
06/25/2010
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