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General NPI Number Information
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NPI Number | 1316630817
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Entity Type | Individual
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Provider Name | MATTHEW STEVEN PHILLIPS DDS
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Gender | Male
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Dates
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Enumeration Date | 05/31/2023
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 934 N GASKILL ST
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City | HUNTSVILLE
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State | AR
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Zip | 72740-8903
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Country | US
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Telephone | 479-738-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 2171 PINE HILL RD
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City | WINFIELD
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State | TN
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Zip | 37892-3425
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Country | US
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Telephone |
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Fax |
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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 | 4670
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License Number State | AR
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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 | 12433
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License Number State | TN
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