Organization
TERRY R. ELLIS, DMD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY R ELLIS DMD (PRESIDENT)
(706) 855-7220
Entity
Organization
Contact information
Practice address
1244 AUGUSTA WEST PKWY, AUGUSTA, GA 30909-1854
(706) 855-7220
(706) 855-7260
Mailing address
1244 AUGUSTA WEST PKWY, AUGUSTA, GA 30909-1854
(706) 855-7220
(706) 855-7260
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
08/21/2013
Last updated
08/21/2013
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