Organization
ELLIS ENDODONTICS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY BRANT ELLIS DDS, MSCD (DOCTOR-OWNER)
(832) 452-3169
Entity
Organization
Contact information
Practice address
303 LONGMIRE RD UNIT 901, CONROE, TX 77304-2101
(936) 760-2222
(936) 760-2233
Mailing address
303 LONGMIRE RD UNIT 901, CONROE, TX 77304-2101
(936) 760-2222
(936) 760-2233
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Enumeration date
01/19/2019
Last updated
01/19/2019
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