Individual
DR. JEFFREY SCOTT ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
160 S 100 W, HEBER CITY, UT 84032-2015
(435) 654-5322
Mailing address
608 E 600 S, HEBER CITY, UT 84032-3868
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
6217681-9922
UT
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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