Ellis, Roger Terry
Ellis, Roger Terry is an individual health care provider with primary practice located at 1718 Memorial Dr , Clarksville TN 37043-4542. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Ellis, Roger Terry can be contacted via phone (931) 552-4935.Contact Information
Primary practice address
1718 Memorial Dr
Clarksville TN 37043-4542
Phone: (931) 552-4935
Fax: (931) 552-0959
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 4003 | Tennessee |
Profile Details
| NPI number | 1396759189 |
|---|---|
| LBN Legal business name | Ellis, Roger Terry |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 28th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
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