Ellis Orthodontics, LLC

NPI #1700070331 in Dyer, Indiana

Provider Information

NPI Number
1700070331
Entity Type
Organization
Organization Name
Ellis Orthodontics, LLC
Primary Specialty
Dentist - Orthodontics and Dentofacial Orthopedics
Enumeration Date
Aug 27, 2007
Last Updated
Aug 27, 2007

Practice Location

Address
275 US HIGHWAY 30
Address 2
SUITE 260
City
Dyer
State
Indiana
ZIP Code
46311-1776
Phone
(219) 322-7645

Authorized Official

Name
DR. LAWRENCE CHARLES ELLIS, DDS, MSD
Title
ORTHODONTIST
Phone
(219) 322-7645

Specialties & Taxonomy Codes

Specialty
Dentist - Orthodontics and Dentofacial OrthopedicsOrthodontics and Dentofacial Orthopedics

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