Individual
JOHN JOSEPH ELLWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
222 MERRICK AVE, MERRICK, NY 11566-3143
(516) 379-4444
Mailing address
8 FOX LN, COMMACK, NY 11725-2005
(516) 379-4444
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
046117
NY
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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