Individual
DR. RYAN ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5479 N FRESNO ST STE 104, FRESNO, CA 93710-8328
(559) 439-5280
Mailing address
1495 10TH AVE APT 3, SAN FRANCISCO, CA 94122-3670
(415) 420-2824
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
53786
CA
Other
Enumeration date
02/27/2009
Last updated
02/27/2009
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