Randal W Ellis Dmd Pllc
NPI #1326051285 in Everson, Washington
Provider Information
- NPI Number
- 1326051285
- Entity Type
- Organization
- Organization Name
- Randal W Ellis Dmd Pllc
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Aug 14, 2006
- Last Updated
- May 3, 2012
Practice Location
- Address
- 3739 MT BAKER HWY
- City
- Everson
- State
- Washington
- ZIP Code
- 98247-9406
- Phone
- (360) 592-1100
Authorized Official
- Name
- RANDAL W ELLIS, DMD
- Title
- DENTIST/OWNER
- Phone
- (360) 592-1100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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