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General NPI Number Information
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NPI Number | 1336269620
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Entity Type | Organization
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Legal Business Name | PHILIP A. PHILBIN, D.D.S., P.A.
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 104 FORBES ST SUITE 204
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City | ANNAPOLIS
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State | MD
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Zip | 21401-1516
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Country | US
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Telephone | 410-263-5600
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Fax | 410-263-9722
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Provider Business Mailing Address
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Address Line | 226 LOOKOUT LN
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City | ANNAPOLIS
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State | MD
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Zip | 21409-6306
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Country | US
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Telephone | 410-757-1522
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Fax | 410-263-9722
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Authorized Official
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Title or Position | OWNER
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Name | DR. PHILIP AUGUST PHILBIN
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Credential | D.D.S
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Telephone | 410-263-5600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 09549
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License Number State | MD
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