Individual
DR. ELLIS KNOX LIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1014 LAMOND AVE, DURHAM, NC 27701-2021
(919) 682-5327
(919) 688-4588
Mailing address
1014 LAMOND AVE, DURHAM, NC 27701-2021
(919) 682-5327
(919) 688-4588
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
30-01-8657
OH
1223G0001X
General Practice Dentistry
Primary
5687
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27028-1
BLUE CROSS/BLUE SHIELD #
NC
Enumeration date
06/10/2005
Last updated
07/08/2007
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