Ellis, Terry Randal
Ellis, Terry Randal is an individual health care provider with primary practice located at 1244 Augusta West Parkway , Augusta GA 30909. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Ellis, Terry Randal can be contacted via phone (706) 855-7220.Contact Information
Primary practice address
1244 Augusta West Parkway
Augusta GA 30909
Phone: (706) 855-7220
Fax: (706) 855-7260
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | DN011393 | Georgia |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 254190 | Mississippi |
Profile Details
| NPI number | 1255307831 |
|---|---|
| LBN Legal business name | Ellis, Terry Randal |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 24th, 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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