Individual
DR. JONATHAN HUNTER ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3314 OAKLAWN BLVD, HOPEWELL, VA 23860
(804) 458-6733
(804) 541-0416
Mailing address
12907 SCRIMSHAW CIRCLE, CHESTER, VA 23836
(804) 553-0848
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401411395
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9182623
—
VA
Enumeration date
09/21/2006
Last updated
07/08/2007
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