Individual
BRADYN REIS ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1055 W FAIRVIEW ST, COLFAX, WA 99111-5106
(509) 397-4077
Mailing address
406 E THORN ST, COLFAX, WA 99111-1616
(509) 553-9084
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
61316972
WA
Other
Enumeration date
08/03/2022
Last updated
08/03/2022
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