Ellis, Wayne R.
Ellis, Wayne R. is an sole proprietor health care provider with primary practice located at 6363 W Emerald St Building 102, Boise ID 83704-8783. He recently has only one registered license in Dental Providers / Endodontics, which is considered as his primary health care specialty. Ellis, Wayne R. can be contacted via phone (208) 376-6307.Contact Information
Primary practice address
6363 W Emerald St Building 102
Boise ID 83704-8783
Phone: (208) 376-6307
Fax: (208) 376-9011
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Endodontics | 1223E0200X | D-1522 | Idaho |
Profile Details
| NPI number | 1427166024 |
|---|---|
| LBN Legal business name | Ellis, Wayne R. |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 25th, 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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