Ellis, Kaitlyn

Ellis, Kaitlyn is an individual health care provider with primary practice located at 1008 Mission Park Dr , Vicksburg MS 39180-3735. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Ellis, Kaitlyn can be contacted via phone (601) 627-4100.

Contact Information

Primary practice address
1008 Mission Park Dr Vicksburg MS 39180-3735
Fax: (601) 629-4101
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 387216 Mississippi

Profile Details

NPI number 1548611098
LBN Legal business name Ellis, Kaitlyn
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2016
Last updated Jun 27th, 2016 - 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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