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Individual

DR. DONALD MICHAEL ELLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
4600 JOHN MARR DR STE 401, ANNANDALE, VA 22003-3310
(703) 750-9393
(703) 750-5420
Mailing address
4600 JOHN MARR DR STE 401, ANNANDALE, VA 22003-3310
(703) 750-9393
(703) 750-5420

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0401411131
VA

Other

Enumeration date
11/22/2006
Last updated
07/08/2007
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