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Individual

DR. ELLIS TAYLOR MULLINAX

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
UNIT 26610, WUERZBURG DENTAL ACTIVITY CREDENTIALS OFFICE, APO AE, NY 09244
(931) 804-3933
Mailing address
UNIT 26610, WUERZBURG DENTAL ACTIVITY CREDENTIALS OFFICE, APO AE, NY 09244
(931) 804-3933

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2776
AL

Other

Enumeration date
05/02/2006
Last updated
07/08/2007
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