Individual
DR. EARL ELLIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S
Contact information
Practice address
606 FISHER ST, BILOXI, MS 39534-2513
(228) 377-4510
Mailing address
2475 PROVENCE PL, BILOXI, MS 39531-2285
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
14, 622
TX
Other
Enumeration date
04/01/2006
Last updated
07/08/2007
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