Ellis, Kenneth Clay
Ellis, Kenneth Clay is an sole proprietor health care provider with primary practice located at 311 S 5Th St Ste A , Gadsden AL 35901-4253. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Ellis, Kenneth Clay can be contacted via phone (256) 543-1285.Contact Information
Primary practice address
311 S 5Th St Ste A
Gadsden AL 35901-4253
Phone: (256) 543-1285
Fax: (256) 543-1719
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 3842 | Alabama |
Profile Details
| NPI number | 1639278039 |
|---|---|
| LBN Legal business name | Ellis, Kenneth Clay |
| Credentials | DMD, LLC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 22nd, 2006 |
| Last updated | Jun 14th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639278039 | NPPES |
| Alabama | MEDICAID | 008303580 |
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