Individual
DR. ALEXA BRADY ELLINGSEN ROEHRIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3425 ERIE BLVD E, DE WITT, NY 13214-1635
(315) 445-9400
Mailing address
1509 W PINEHILL RD, SPOKANE, WA 99218-2946
(509) 389-6769
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
060673-01
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/15/2018
Last updated
09/05/2019
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