| Randall A. Ellis, Dds, Pllc | |
|
4617 Summerhill Rd Ste 3 Texarkana TX 75503-2783 | |
| (903) 838-5506 | |
| Not Available |
| Full Name | Randall A. Ellis, Dds, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4617 Summerhill Rd Ste 3, Texarkana, Texas |
| Authorized Official Name and Position | Randall Allen Ellis (OWNER/DENTIST) |
| Authorized Official Contact | 9038385506 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Randall A. Ellis, Dds, Pllc 4617 Summerhill Rd Ste 3 Texarkana TX 75503-2783 Ph: (039) 838-5506 | Randall A. Ellis, Dds, Pllc 4617 Summerhill Rd Ste 3 Texarkana TX 75503-2783 Ph: (903) 838-5506 |
| NPI Number | 1114619657 |
|---|---|
| Provider Enumeration Date | 05/23/2023 |
| Last Update Date | 05/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114619657 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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