Organization
JESS T ELLIS DDS, MS, INC
Active
Parent organization
JESS T ELLIS DDS, MS, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
JESS T ELLIS DDS, MS, INC
Authorized official
DR. JESS T ELLIS DDS, MS (PRESIDENT)
(907) 272-3636
Entity
Organization
Contact information
Practice address
11741 BARR RD, ANCHORAGE, AK 99516-2164
(907) 272-3636
(907) 272-3635
Mailing address
11741 BARR RD, ANCHORAGE, AK 99516-2164
(907) 272-3636
(907) 272-3635
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
682
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3072011582976
—
AK
Enumeration date
06/26/2013
Last updated
06/26/2013
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