Individual
DR. JESSE ELLEDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
105 NUCLEUS AVE, COLUMBIA FALLS, MT 59912-4010
(530) 446-4714
Mailing address
PO BOX 1866, COLUMBIA FALLS, MT 59912-1866
(406) 892-2104
(406) 892-1422
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19915
MT
Other
Enumeration date
10/23/2018
Last updated
09/24/2021
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