Organization
BRENT L ELLIS DDS PC
Active
Other names
SMILE DESIGNERS
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT L ELLIS DDS (OWNER)
(812) 847-8601
Entity
Organization
Contact information
Practice address
290 A ST SE, LINTON, IN 47441-1844
(812) 847-8601
(812) 847-8750
Mailing address
PO BOX 635, LINTON, IN 47441-0635
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/09/2023
Last updated
03/09/2023
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