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General NPI Number Information
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NPI Number | 1043452758
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Entity Type | Individual
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Provider Name | BARBARA LYNN PHILLIPS DMD
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Gender | Female
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Dates
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Enumeration Date | 03/26/2009
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Last Update Date | 09/25/2013
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Provider Practice Location Address
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Address Line | 8815 COUNTY RD J
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City | WOODRUFF
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State | WI
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Zip | 54568-9636
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Country | US
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Telephone | 715-358-0502
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Fax | 715-358-0504
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Provider Business Mailing Address
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Address Line | PO BOX 890
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City | WOODRUFF
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State | WI
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Zip | 54568-0890
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Country | US
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Telephone | 715-358-0502
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Fax | 715-358-0504
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 6748-015
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License Number State | WI
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