Organization
J. SCOTT ELLIS, D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN SCOTT ELLIS D.D.S. (PRESIDENT)
(903) 561-3756
Entity
Organization
Contact information
Practice address
5615 OLD BULLARD RD, TYLER, TX 75703-4306
(903) 561-3756
Mailing address
5615 OLD BULLARD RD, TYLER, TX 75703-4306
(903) 561-3756
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12185
TX
Other
Enumeration date
11/01/2006
Last updated
08/22/2020
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