DR. Ellis Chan Back, DDS
NPI #1841064094 in Vallejo, California
Provider Information
- NPI Number
- 1841064094
- Entity Type
- Individual
- Name
- DR. Ellis Chan Back, DDS
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist
- Credential
- DDS
- Enumeration Date
- Nov 8, 2023
- Last Updated
- Nov 8, 2023
Practice Location
- Address
- 3587 SONOMA BLVD
- City
- Vallejo
- State
- California
- ZIP Code
- 94590-2945
- Phone
- (925) 683-4799
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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