Search › Utah › 1223G0001X
Preston Ellis, MS, DDS
NPI 1518215458 · on the registry since 2012 · sole proprietor
Practice
- Address
- 3575 N 100 E Ste 200
Provo, UT 84604 - Phone
- (801) 374-0070
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 1223G0001X
1223G0001X
- Licence states on file
- UT
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2012-08-27
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 Utah