Individual
CHRISTINE PORTER ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7201
(214) 645-3999
(214) 648-2918
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(214) 645-3999
(214) 648-2918
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
18307
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164228201
—
TX
Enumeration date
04/18/2006
Last updated
03/11/2010
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