Individual
DR. MEHRL KECK ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.,P.C.
Contact information
Practice address
111 W WIGWAM BLVD, SUITE A, LITCHFIELD PARK, AZ 85340-4636
(623) 935-9376
Mailing address
111 W WIGWAM BLVD, SUITE A, LITCHFIELD PARK, AZ 85340-4636
(623) 935-9376
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D2187
AZ
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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