Most Relevant Information
Provider Data
| NPI Number: | 1003314535 |
| Provider Name: | EVAN BALE ELLSWORTH DMD |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | 7010 |
Most Important Dates
| Enumeration Date: | 01/30/2018 |
| Last Updated: | 03/17/2019 |
Provider Practice Location
2660 WINDMILL PKWY
HENDERSON
NV
890743385
Practice Location Phone/Fax
| Phone: | 7029902960 |
| Fax: |
Provider Mailing Location
6127 S RAINBOW BLVD STE 100
LAS VEGAS
NV
891183256
Provider Mailing Phone/Fax
| Phone: | 7027932182 |
| Fax: |