Wayne Ellis, D.D.S

NPI 1427166024 · on the registry since 2006 · sole proprietor

Practice

Address: 6363 W Emerald St
Building 102
Boise, ID 83704
Phone: (208) 376-6307
Fax: (208) 376-9011
Organisation at this address: Scott Freeman, D.M.D., P.A.
Boise Family Dental Care, Pllc
Boise Oral And Maxillofacial Surgery
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 3

Registry record

Primary taxonomy: 1223E0200X
1223E0200X
Licence states on file: ID
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho