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
Phone: (601) 627-4100
Fax: (601) 629-4101
Website:
Health care specialties
| Specialty | Code | License # | 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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