Individual
ALYSSA ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4150 DARLEY AVE STE 3, BOULDER, CO 80305-6537
(303) 499-0013
Mailing address
2258 W 35TH AVE, DENVER, CO 80211-2908
(314) 809-9609
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
00202776
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/27/2015
Last updated
01/09/2019
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