| J. Scott Ellis, D.d.s. | |
|
5615 Old Bullard Rd Tyler TX 75703-4306 | |
| (903) 561-3756 | |
| Not Available |
| Full Name | J. Scott Ellis, D.d.s. |
|---|---|
| Speciality | Dentist |
| Location | 5615 Old Bullard Rd, Tyler, Texas |
| Authorized Official Name and Position | John Scott Ellis (PRESIDENT) |
| Authorized Official Contact | 9035613756 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J. Scott Ellis, D.d.s. 5615 Old Bullard Rd Tyler TX 75703-4306 Ph: (903) 561-3756 | J. Scott Ellis, D.d.s. 5615 Old Bullard Rd Tyler TX 75703-4306 Ph: (903) 561-3756 |
| NPI Number | 1457439846 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457439846 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12185 (Texas) | Primary |
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