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Individual

DR. ELLIS BURKE JARDINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
406C SE 131ST AVENUE, SUITE 305, VANCOUVER, WA 98683-4003
(360) 253-9792
Mailing address
3542 NE FRANKLIN ST, CAMAS, WA 98607-6904
(480) 862-3185

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
7240
AZ
1223P0700X
Prosthodontics
27917
TX
1223P0700X
Prosthodontics
9441
TN
1223P0700X
Prosthodontics
DE 60339865
WA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DE60339865
WA

Other

Enumeration date
06/27/2007
Last updated
03/07/2023
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