Individual
DR. JASON S ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
440 COBURG RD, SUITE 104, EUGENE, OR 97401-5541
(541) 343-1877
(541) 924-9664
Mailing address
440 COBURG RD, SUITE 104, EUGENE, OR 97401-5541
(541) 343-1877
(541) 924-9664
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9724
OR
Other
Enumeration date
06/12/2012
Last updated
06/12/2012
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