Eric Edward Ellis, DMD

NPI #1093971749 in Peoria, Arizona

Provider Information

NPI Number: 1093971749
Entity Type: Individual
Name: Eric Edward Ellis, DMD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: DMD
Enumeration Date: Aug 1, 2008
Last Updated: Nov 9, 2010

Practice Location

Address: 31307 N 137TH AVE
City: Peoria
State: Arizona
ZIP Code: 85383-7941
Phone: (586) 322-9041

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary
Dentist - Pediatric Dentistry — Pediatric Dentistry	1223P0221X

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