Ellis, Robert H.
Ellis, Robert H. is an sole proprietor health care provider with primary practice located at 8905 Two Notch Rd , Columbia SC 29223-6367. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Ellis, Robert H. can be contacted via phone (803) 788-9593.Contact Information
Primary practice address
8905 Two Notch Rd
Columbia SC 29223-6367
Phone: (803) 788-9593
Fax: (803) 788-3123
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 1266 | South Carolina |
Profile Details
| NPI number | 1487615001 |
|---|---|
| LBN Legal business name | Ellis, Robert H. |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 31st, 2006 |
| Last updated | Sep 11th, 2014 - about 11 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 | 1487615001 | NPPES |
| South Carolina | MEDICAID | Z12665 | |
| South Carolina | MEDICAID | ZA9724 |
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