Organization
ELLIS PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ELLIS DDS, MSD (DENTIST)
(317) 859-9450
Entity
Organization
Contact information
Practice address
910 AVERITT RD, GREENWOOD, IN 46143-9540
(317) 859-9450
(317) 859-9475
Mailing address
910 AVERITT RD, GREENWOOD, IN 46143-9540
(317) 859-9450
(317) 859-9475
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
04/07/2026
Last updated
04/07/2026
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