Individual
MADISON ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1196 PROFESSIONAL DR, VAN WERT, OH 45891-2461
(419) 238-1219
Mailing address
1196 PROFESSIONAL DR, VAN WERT, OH 45891-2461
(419) 238-1219
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30.028449
OH
Other
Enumeration date
05/14/2026
Last updated
05/14/2026
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