Individual
DR. ETHAN MATTHEW ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1210 E 8TH ST STE 2, WESLACO, TX 78596-7120
(956) 969-2591
(956) 969-3855
Mailing address
1714 STRAWBERRY HL, EDINBURG, TX 78541-7901
(940) 521-8210
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
39621
TX
Other
Enumeration date
06/14/2023
Last updated
06/10/2025
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