| Ellis Pediatric Dentistry | |
|
910 Averitt Rd Greenwood IN 46143-9540 | |
| (317) 859-9450 | |
| (317) 859-9475 |
| Full Name | Ellis Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 910 Averitt Rd, Greenwood, Indiana |
| Authorized Official Name and Position | Mark Ellis (DENTIST) |
| Authorized Official Contact | 3178599450 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellis Pediatric Dentistry 910 Averitt Rd Greenwood IN 46143-9540 Ph: (317) 859-9450 | Ellis Pediatric Dentistry 910 Averitt Rd Greenwood IN 46143-9540 Ph: (317) 859-9450 |
| NPI Number | 1942142286 |
|---|---|
| Provider Enumeration Date | 04/07/2026 |
| Last Update Date | 04/07/2026 |
| Certification Date | 04/07/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942142286 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | () | Primary |
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