Organization
MARK A. ELLIS, DMD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK ELLIS DMD (PRESIDENT)
(423) 805-7500
Entity
Organization
Contact information
Practice address
951 RIVERFRONT PKWY, SUITE 302, CHATTANOOGA, TN 37402-2185
(423) 805-7500
Mailing address
951 RIVERFRONT PKWY, SUITE 302, CHATTANOOGA, TN 37402-2185
(423) 805-7500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9594
TN
Other
Enumeration date
03/06/2014
Last updated
03/06/2014
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