Individual
DR. EJIKE BARTHOLOMEW EZEJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1609 NORMAN RD STE B, ASPEN DENTAL, SAINT PAUL, GA 31601-4201
(229) 269-4607
Mailing address
1159 FIFIELD AVE, APT. N4, SAINT PAUL, MN 55108-1108
(612) 598-3786
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D13431
MN
122300000X
Dentist
Primary
DN014878
GA
Other
Enumeration date
06/23/2014
Last updated
09/26/2014
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