| Richard T. Ellison, Dds, Inc | |
|
1602 W Jackson St Muncie IN 47303-4962 | |
| (765) 289-0236 | |
| (765) 289-8569 |
| Full Name | Richard T. Ellison, Dds, Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1602 W Jackson St, Muncie, Indiana |
| Authorized Official Name and Position | Sherri J Richardson (OFFICE MANAGER) |
| Authorized Official Contact | 7652890236 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard T. Ellison, Dds, Inc 1602 W Jackson St Muncie IN 47303-4962 Ph: (765) 289-0236 | Richard T. Ellison, Dds, Inc 1602 W Jackson St Muncie IN 47303-4962 Ph: (765) 289-0236 |
| NPI Number | 1740661834 |
|---|---|
| Provider Enumeration Date | 06/15/2015 |
| Last Update Date | 06/15/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740661834 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 6592 (Indiana) | Primary |
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