DR. John Gerald Ellison, D.D.S.

NPI #1609128065 in Vincennes, Indiana

Provider Information

NPI Number: 1609128065
Entity Type: Individual
Name: DR. John Gerald Ellison, D.D.S.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: D.D.S.
Enumeration Date: Oct 10, 2012
Last Updated: Oct 10, 2012

Practice Location

Address: 1658 WASHINGTON AVE
City: Vincennes
State: Indiana
ZIP Code: 47591-4842
Phone: (812) 882-6098

Specialties & Taxonomy Codes

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

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