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General NPI Number Information
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NPI Number | 1306579982
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Entity Type | Organization
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Legal Business Name | DANIEL STEPHEN PHILLIPS, D.D.S., LLC
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Dates
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Enumeration Date | 07/01/2022
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Last Update Date | 07/01/2022
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Provider Practice Location Address
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Address Line | 1440 W HIGH ST STE 1
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City | ORRVILLE
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State | OH
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Zip | 44667-1444
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Country | US
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Telephone | 330-683-1906
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Fax |
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Provider Business Mailing Address
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Address Line | 1440 W HIGH ST STE 1
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City | ORRVILLE
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State | OH
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Zip | 44667-1444
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Country | US
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Telephone | 330-683-1906
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Fax |
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | DR. DANIEL PHILLIPS
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Credential | DDS
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Telephone | 330-860-7054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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