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Dr. Mark Allen Ellis, DDS
Pediatric Dentist in Greenwood, Indiana
NPI 1184719262

Mark Allen Ellis is a Pediatric Dentist based in Greenwood, IN and is specialized in Pediatric Dentistry. Mark Allen Ellis practices in Greenwood, IN and has the professional credentials of DDS. The NPI Number for Mark Allen Ellis is 1184719262 and holds a License No. 12010547A (Indiana).

The current practice location address for Mark Allen Ellis is 910 Averitt Rd, Greenwood, IN and can be reached out via phone at 317-859-9450 and via fax at 317-859-9475.

Location: 910 Averitt Rd, Greenwood, IN, 46143-9540
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1184719262
Provider Name
Mark Allen Ellis
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
910 Averitt Rd, Greenwood, IN, 46143-9540
Phone Number
317-859-9450
Fax Number
317-859-9475
Provider Enumeration Date
10/04/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
200500300 05 IN
institution
Provider Business Practice Location Address Details
Address
910 Averitt Rd
City
Greenwood
State
Indiana
Zip
46143-9540
Phone Number
317-859-9450
Fax Number
317-859-9475
person
Provider Business Mailing Address Details
Address
910 Averitt Rd
City
Greenwood
State
Indiana
Zip
46143-9540
Phone Number
317-859-9450
Fax Number
317-859-9475
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
12010547A (Indiana)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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