Organization
DR. EDA ELLIS DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDA ELLIS (OWNER)
(212) 753-1119
Entity
Organization
Contact information
Practice address
30 CENTRAL PARK S, SUITE 7A, NEW YORK, NY 10019-1628
(212) 753-1119
(212) 753-1139
Mailing address
30 CENTRAL PARK S, SUITE 7A, NEW YORK, NY 10019-1628
(212) 753-1119
(212) 753-1139
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
04/19/2017
Last updated
04/19/2017
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