Individual
MRS. DEEANNA LEE ELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ROH
Contact information
Practice address
1134 N BRAND BLVD, GLENDALE, CA 91202
(818) 246-2253
Mailing address
1300 BEAUDRY BLVD, GLENDALE, CA 91208
(818) 957-5654
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
10263
CA
Other
Enumeration date
09/15/2006
Last updated
07/08/2007
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