DR. Wayne R. Ellis, D.D.S.

NPI #1427166024 in Boise, Idaho

Provider Information

NPI Number: 1427166024
Entity Type: Individual
Name: DR. Wayne R. Ellis, D.D.S.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - Endodontics
Credential: D.D.S.
Enumeration Date: Aug 25, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 6363 W EMERALD ST
Address 2: BUILDING 102
City: Boise
State: Idaho
ZIP Code: 83704-8783
Phone: (208) 376-6307

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Endodontics — Endodontics	1223E0200X	Primary

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