Dr. CHARLES LEE ELLIS DDS, MD
Individual Provider (NPI-1)
Active
Dentist, Oral and Maxillofacial Surgery
Provider Information
- NPI Number
1013098698- Provider Type
- Individual Provider (NPI-1)
- Credentials
- DDS, MD
- Status
- Active
Contact & Location
- Address
- 2353 S RIDGE ROAD, GREEN BAY, WI, 543045069
- Phone
- (920) 499-0471
- Fax
- (920) 499-8312
Specialties & Taxonomies
Dentist
License: NC #8919
Dentist, Oral and Maxillofacial Surgery
License: VA #0401411258
Dentist, Oral and Maxillofacial Surgery
License: IL #019022235
Oral & Maxillofacial Surgery
License: VA #0101058265
Oral & Maxillofacial Surgery
License: NC #8919
Dentist, Oral and Maxillofacial Surgery
Primary License: NC #8919