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General NPI Number Information
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NPI Number | 1033132402
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Entity Type | Organization
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Legal Business Name | PHILIPD HIGH, DDS., INC
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 08/31/2007
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Provider Practice Location Address
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Address Line | 1203 MOUNT DE CHANTAL RD
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City | WHEELING
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State | WV
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Zip | 26003-6332
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Country | US
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Telephone | 304-242-5671
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Fax | 304-242-0641
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Provider Business Mailing Address
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Address Line | 1203 MT DECHANTAL RD
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City | WHEELING
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State | WV
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Zip | 26003
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Country | US
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Telephone | 304-242-5671
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Fax | 304-242-0641
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. JO DONAHUE
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Credential |
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Telephone | 304-242-0641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number | 2039
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License Number State | WV
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