Individual
JARED SCOTT ELLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
112 DR. THATYE DRIVE, GLANDORF, OH 45848-0040
(419) 419-3334
(419) 463-9024
Mailing address
112 DR. THATYE DRIVE, P.O. BOX 40, GLANDORF, OH 45848-0040
(419) 419-3334
(419) 463-9024
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30025377
OH
Other
Enumeration date
06/05/2018
Last updated
06/05/2018
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