person
Mr. Fred E Ellis, DPDDENTURISTOFPRO
Denturist in Olympia, Washington
NPI 1891835310

Fred E Ellis is a Denturist based in Olympia, WA. Fred E Ellis practices in Olympia, WA and has the professional credentials of DPDDENTURISTOFPRO. The NPI Number for Fred E Ellis is 1891835310 and holds a License No. DN00000358 (Washington).

The current practice location address for Fred E Ellis is 1822 Black Lake Blvd Sw, Olympia, WA and can be reached out via phone at 360-709-9909 and via fax at 360-709-9915.

Location: 1822 Black Lake Blvd Sw, Olympia, WA, 98512
person
Provider Profile Details
NPI Number
1891835310
Provider Name
Fred E Ellis
Credential
DPDDENTURISTOFPRO
Provider Entity Type
Individual
Gender
Male
Address
1822 Black Lake Blvd Sw, Olympia, WA, 98512
Phone Number
360-709-9909
Fax Number
360-709-9915
Provider Enumeration Date
02/07/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
5046370 05 WA
institution
Provider Business Practice Location Address Details
Address
1822 Black Lake Blvd Sw
City
State
Zip
98512
Phone Number
360-709-9909
Fax Number
360-709-9915
person
Provider Business Mailing Address Details
Address
1822 Black Lake Blvd Sw
City
State
Zip
98512
Phone Number
360-709-9909
Fax Number
360-709-9915
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Denturist
Speciality
-
Taxonomy
License No.
DN00000358 (Washington)
Definition
Definition to come.
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