Individual
DR. ROBERT P ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
615 PROFESSIONAL PARK DR, NEW HAVEN, IN 46774-1850
(260) 493-2113
(260) 493-1896
Mailing address
615 PROFESSIONAL PARK DR, NEW HAVEN, IN 46774-1850
(260) 493-2113
(260) 493-1896
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
IN6593
IN
Other
Enumeration date
09/12/2011
Last updated
09/12/2011
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