Thomas Alan Ellisor, D.D.S. Valid NPI
Individual provider · Dentist · Lake Jackson, TX
- NPI
- 1649617838
- Type
- Individual (Type 1)
- Primary specialty
- Dentist
- Specialty group
- Dental Providers
- Taxonomy code
- 122300000X
- License number
- 28931 (TX)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2013-05-28
- Last updated
- 2013-05-28
Practice location
103 N Dixie Dr
Lake Jackson, TX 77566-5940
(979) 297-6438