| Ellis Dental Care | |
|
17583 Old Jefferson Hwy Prairieville LA 70769-3930 | |
| (225) 673-2200 | |
| (225) 673-2210 |
| Full Name | Ellis Dental Care |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 17583 Old Jefferson Hwy, Prairieville, Louisiana |
| Authorized Official Name and Position | David Michael Ellis (DENTIST/OWNER) |
| Authorized Official Contact | 2256732200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellis Dental Care 17583 Old Jefferson Hwy Prairieville LA 70769-3930 Ph: (225) 673-2200 | Ellis Dental Care 17583 Old Jefferson Hwy Prairieville LA 70769-3930 Ph: (225) 673-2200 |
| NPI Number | 1710092937 |
|---|---|
| Provider Enumeration Date | 08/20/2006 |
| Last Update Date | 02/10/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710092937 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5098 (Louisiana) | Primary |
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