DR. Kaitlyn Ellis, D.M.D.

NPI #1548611098 in Vicksburg, Mississippi

Provider Information

NPI Number: 1548611098
Entity Type: Individual
Name: DR. Kaitlyn Ellis, D.M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: D.M.D.
Enumeration Date: Jun 27, 2016
Last Updated: Jun 27, 2016

Practice Location

Address: 1008 MISSION PARK DR
City: Vicksburg
State: Mississippi
ZIP Code: 39180-3735
Phone: (601) 627-4100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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