Individual
LEN I ELLIS II
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4600 CHURCH RD, MOUNT LAUREL, NJ 08054-3200
(856) 638-1800
(856) 638-1871
Mailing address
4600 CHURCH RD, MOUNT LAUREL, NJ 08054-3200
(856) 638-1800
(856) 638-1871
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
19835
NJ
Other
Enumeration date
12/23/2005
Last updated
07/09/2007
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