Individual
JOHN BOCKHOFF ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2901 S FLORIDA AVE, LAKELAND, FL 33803-4032
(863) 682-8001
(863) 682-4943
Mailing address
2901 S FLORIDA AVE, LAKELAND, FL 33803-4032
(863) 682-8001
(863) 682-4943
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8151
FL
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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