Individual
DR. MITCHELL WARD ELLINGSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4530 E SHEA BLVD, PHOENIX, AZ 85028-6065
(602) 992-4510
Mailing address
4025 N FOUNDER CIR, BUCKEYE, AZ 85396-3686
(623) 377-6185
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7229
AZ
Other
Enumeration date
05/31/2007
Last updated
02/22/2012
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