DR. Richard D. Ellsworth, DDS

NPI #1083714885 in Lafayette, Indiana

Provider Information

NPI Number
1083714885
Entity Type
Individual
Name
DR. Richard D. Ellsworth, DDS
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Dentist - General Practice
Credential
DDS
Enumeration Date
Sep 22, 2006
Last Updated
Jul 8, 2007

Practice Location

Address
150 PROFESSIONAL CT.
Address 2
STE A
State
Indiana
ZIP Code
47905-5153
Phone
(765) 449-2757

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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