Organization
DAVID L. ELLIS, DDS, LTD
Active
Other names
Ellis Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIA C ELLIS (OFFICE MANAGER)
(804) 458-6733
Entity
Organization
Contact information
Practice address
3416 WOODLAWN ST, HOPEWELL, VA 23860-4738
(804) 458-6733
Mailing address
3416 WOODLAWN ST, HOPEWELL, VA 23860-4738
(804) 458-6733
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
11395
VA
261QD0000X
Dental Clinic/Center
Primary
5245
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9179650
—
VA
05
—
9182633
—
VA
Enumeration date
11/19/2007
Last updated
11/19/2007
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