IndividualActive
Fred Ellis, DPD DENTURIST OF PRO
NPI 1891835310 · Denturist · Olympia, WA
Provider details
- NPI number
- 1891835310
- Entity type
- Individual
- Primary specialty
- DenturistDental Providers
- Credential
- DPD DENTURIST OF PRO
- Sex
- Male
- Sole proprietor
- No
- License
- DN00000358 (WA)
Specialties & taxonomies
Dental Providers
Practice location
1822 Black Lake Blvd Sw
Suite 101
Olympia, WA 98512
Phone: (360) 709-9909
Fax: (360) 709-9915
Approximate (ZIP-level) locationGet directions
Mailing address
1822 Black Lake Blvd Sw
Olympia, WA 98512
Registry dates
- Enumerated
- 2007-02-07
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.