Organization
CRYSTAL ELLIS DDS, LLC.
Active
Other names
The Smile Suite
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRYSTAL GORDON ELLIS DDS (MANAGING OWNER)
(240) 565-8159
Entity
Organization
Contact information
Practice address
8455 COLESVILLE RD, SUITE 102, SILVER SPRING, MD 20910-3315
(240) 565-8159
Mailing address
8455 COLESVILLE RD, SUITE 102, SILVER SPRING, MD 20910-3315
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14220
MD
Other
Enumeration date
04/23/2012
Last updated
04/23/2012
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