Ellsworth, Samuel Dwayne
Ellsworth, Samuel Dwayne is an individual health care provider with primary practice located at 6333 E Mockingbird Ln Suite 254, Dallas TX 75214-2692. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Periodontics. Dental Providers / Periodontics is his primary health care specialty. Ellsworth, Samuel Dwayne can be contacted via phone (214) 827-9500.Contact Information
Primary practice address
6333 E Mockingbird Ln Suite 254
Dallas TX 75214-2692
Phone: (214) 827-9500
Fax: (214) 827-9502
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Dental Providers / Dentist | 122300000X | 25488 | Texas |
Dental Providers / Periodontics | 1223P0300X | 25488 | Texas |
Profile Details
NPI number | 1891097168 |
---|---|
LBN Legal business name | Ellsworth, Samuel Dwayne |
Credentials | Doctor of Dental Surgery (DDS) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Nov 18th, 2010 |
Last updated | Feb 18th, 2014 - about 10 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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