Individual
DR. TIMOTHY MARK ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD MS PA
Contact information
Practice address
2110 E FLAMINGO DR, BARTOW, FL 33830-4236
(863) 533-3302
(863) 534-3818
Mailing address
2110 E FLAMINGO DR, BARTOW, FL 33830-4236
(863) 533-3302
(863) 534-3818
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN10745
FL
Other
Enumeration date
09/07/2006
Last updated
07/08/2007
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