Individual
DR. JOHN DAVID ELLINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3203 ARCHDALE RD, ARCHDALE, NC 27263
(336) 431-9571
(336) 431-5691
Mailing address
3203 ARCHDALE RD, ARCHDALE, NC 27263
(336) 431-9571
(336) 431-5691
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4055
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8992463
—
NC
01
—
92463
BCBS
—
Enumeration date
10/27/2006
Last updated
07/08/2007
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