Organization
RANDALL A. ELLIS, DDS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL ALLEN ELLIS DDS (OWNER/DENTIST)
(870) 772-1374
Entity
Organization
Contact information
Practice address
312 ARKANSAS BLVD, TEXARKANA, AR 71854-1905
(870) 772-1374
(870) 774-6814
Mailing address
312 ARKANSAS BLVD, TEXARKANA, AR 71854-1905
(870) 772-1374
(870) 774-6814
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/23/2023
Last updated
05/23/2023
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