Individual
DR. JOHN GERALD ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1658 WASHINGTON AVE, VINCENNES, IN 47591-4842
(812) 882-6098
Mailing address
1658 WASHINGTON AVE, VINCENNES, IN 47591-4842
(812) 882-6098
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12006937A
IN
Other
Enumeration date
10/10/2012
Last updated
10/10/2012
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