Healthcare Provider Details

I. General information

NPI: 1396674867
Provider Name (Legal Business Name): ERICA LORENA PHILLIPS D.D.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9700 W LOOMIS RD
FRANKLIN WI
53132-9701
US

IV. Provider business mailing address

9700 W LOOMIS RD
FRANKLIN WI
53132-9701
US

V. Phone/Fax

Practice location:
  • Phone: 414-877-5677
  • Fax:
Mailing address:
  • Phone: 414-877-5677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6002147-15
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: