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General NPI Number Information
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NPI Number | 1154376366
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Entity Type | Individual
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Provider Name | KAREN LYNN PHILLIPS D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | PERRY POINT DVA BLD 23,SERVICE 160
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City | PERRY POINT
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State | MD
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Zip | 21902
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Country | US
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Telephone | 410-642-2411
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Fax | 410-642-1190
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Provider Business Mailing Address
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Address Line | BLD 23, SERVICE 160 PERRY POINT DVA
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City | PERRY POINT
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State | MD
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Zip | 21902
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Country | US
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Telephone | 410-642-2411
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Fax | 410-642-1190
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 09338
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License Number State | MD
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