Individual
DR. DONALD ALAN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2440 MEADOW ST, SAN LUIS OBISPO, CA 93401-5630
(805) 547-9592
Mailing address
2440 MEADOW ST, SAN LUIS OBISPO, CA 93401-5630
(805) 547-9592
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
25135
CA
Other
Enumeration date
01/04/2009
Last updated
01/04/2009
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