Organization
ELLIS DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID MICHAEL ELLIS DDS (DENTIST/OWNER)
(225) 673-2200
Entity
Organization
Contact information
Practice address
17583 OLD JEFFERSON HWY, PRAIRIEVILLE, LA 70769-3930
(225) 673-2200
(225) 673-2210
Mailing address
17583 OLD JEFFERSON HWY, PRAIRIEVILLE, LA 70769-3930
(225) 673-2200
(225) 673-2210
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5098
LA
Other
Enumeration date
08/20/2006
Last updated
02/10/2015
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