Individual
DR. JOHN RICHARD ELLENBECKER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2211 JORDAN AVE, JUNEAU, AK 99801-8050
(907) 789-3696
(907) 789-6852
Mailing address
2211 JORDAN AVE, JUNEAU, AK 99801-8050
(907) 789-3696
(907) 789-6852
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
AA0546
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DD0546
—
AK
Enumeration date
06/18/2008
Last updated
06/18/2008
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