Individual
DR. CHERRYL SUE ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
105 COMMUNITY DR STE A, SEYMOUR, IN 47274-1955
(812) 272-4602
Mailing address
3312 E ROY SCHMALZ CT, BLOOMINGTON, IN 47401-4445
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12013148A
IN
1223G0001X
General Practice Dentistry
Primary
104713
CA
Other
Enumeration date
05/30/2019
Last updated
01/14/2020
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