Individual
DR. JAMES W ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1220 33RD ST, SUITE A, OGDEN, UT 84403-1378
(801) 621-1835
(801) 621-1848
Mailing address
1220 33RD ST, SUITE C, OGDEN, UT 84403-1378
(801) 394-4519
(801) 394-4551
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5664249-9921
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01638969
UNITED CONCORDIA PROV. #
UT
Enumeration date
06/23/2005
Last updated
07/02/2008
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