Scott Bradley Ellis DMD

NPI 1093040800 - Dentist - 122300000X

NPI Details
NPI 1093040800
Gender Male
Enumeration Date 10/13/2009
Last Updated 10/13/2009
Entity Type Individual
Active Over 7 years ago
Practice Location
23520 OVERLAND DR STE 134
DULLES VA, 20166-2197, US
Phone (703) 661-3360
Fax (703) 661-3363
Business Location
23520 OVERLAND DR STE 134
DULLES VA, 20166-2197, US
Phone (703) 661-3360
Fax (703) 661-3363
Toxanomy
Taxonomy Code 122300000X
License State Virginia
License Number 0401411747
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According to our database, Dr. Scott Bradley Ellis DMD NPI is 1093040800, taxonomy code is 122300000X and license number is 0401411747, license state is located at Virginia. Scott Bradley Ellis DMD physically located at 23520 Overland Dr Ste 134, Dulles VA, 20166-2197. NPI Number Scott Bradley Ellis DMD has the Individual type.

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1093040800 NPI number is provided on an as is basis without warranty of any kind. 1093040800 is maintained by the National Plan & Provider Enumeration System. The contents of Scott Bradley Ellis DMD are for informational purposes only.