Organization
ELLOWAY & WONENBERG, D.D.S., A PROFESSIONAL DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERISA SUE ELLOWAY D.D.S. (OWNER)
(707) 442-1140
Entity
Organization
Contact information
Practice address
1519 2ND ST, EUREKA, CA 95501-0701
(707) 442-1140
(707) 442-1038
Mailing address
1519 2ND ST, EUREKA, CA 95501-0701
(707) 442-1140
(707) 442-1038
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
49706
CA
1223P0221X
Pediatric Dentistry
Primary
47254
CA
Other
Enumeration date
03/08/2007
Last updated
09/11/2025
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