Ellis Tooth Fairy Pllc
NPI #1063251171 in Fort Worth, Texas
Provider Information
- NPI Number
- 1063251171
- Entity Type
- Organization
- Organization Name
- Ellis Tooth Fairy Pllc
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- May 20, 2024
- Last Updated
- May 20, 2024
Practice Location
- Address
- 2725 ELLIS AVE
- City
- Fort Worth
- State
- Texas
- ZIP Code
- 76164-7106
- Phone
- (646) 262-6648
Authorized Official
- Name
- YUEXI CHEN, DDS
- Title
- MANANGER
- Phone
- (646) 262-6648
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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