Individual
DR. LYNAE D ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S., M.S.
Contact information
Practice address
1616 N RANDALL AVE, JANESVILLE, WI 53545-1118
(608) 754-4998
(608) 754-5652
Mailing address
1616 N RANDALL AVE, JANESVILLE, WI 53545-1118
(608) 754-4998
(608) 754-5652
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5282015
WI
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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