Organization
BASIC DENTAL OF MESA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA ELLISS DMD (OWNER)
(702) 557-6423
Entity
Organization
Contact information
Practice address
6238 N MESA ST, EL PASO, TX 79912-4520
(940) 220-4983
Mailing address
1805 HINKLE DR STE 100, DENTON, TX 76201-1768
(940) 220-4983
(940) 387-1264
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
25432
TX
Other
Enumeration date
03/15/2011
Last updated
03/15/2011
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