Individual
DR. KAYLA MARIE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
7150 VALLEY CREEK PLZ STE 230, SAINT PAUL, MN 55125-2271
(651) 217-8296
Mailing address
753 CRESTVIEW DR N, SAINT PAUL, MN 55119-3280
(952) 715-1293
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D14773
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/23/2022
Last updated
06/17/2022
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