Individual
DR. GARY LYNN ELLIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
500 CHIPETA WAY, SALT LAKE CITY, UT 84108-1221
(801) 583-2787
(801) 584-5255
Mailing address
500 CHIPETA WAY, SALT LAKE CITY, UT 84108-1221
(801) 583-2787
(801) 584-5255
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
5129775-9921
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5129775-9921
DENTAL LICENSE
UT
Enumeration date
04/14/2006
Last updated
07/08/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us