Individual
DAVID ALAN ELLSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
523 W JEFFERSON ST, PETOSKEY, MI 49770-2271
(231) 347-8899
Mailing address
523 W JEFFERSON ST, PETOSKEY, MI 49770-2271
(231) 347-8899
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18740
MI
Other
Enumeration date
11/06/2007
Last updated
11/06/2007
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