Renalla Kaye Ellis, DDS

NPI #1548319130 in Shawnee, Oklahoma

Provider Information

NPI Number: 1548319130
Entity Type: Individual
Name: Renalla Kaye Ellis, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Jan 10, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 2510 E INDEPENDENCE ST
City: Shawnee
State: Oklahoma
ZIP Code: 74804-1839
Phone: (405) 273-2002

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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