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General NPI Number Information
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NPI Number | 1356235998
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Entity Type | Individual
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Provider Name | PHILLIP FROMM DMD
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Gender | Male
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Dates
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Enumeration Date | 06/06/2025
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 18855 N 83RD AVE
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City | PEORIA
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State | AZ
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Zip | 85382-2806
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Country | US
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Telephone | 623-887-6005
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Fax |
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Provider Business Mailing Address
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Address Line | 6800 E MAYO BLVD APT 4302
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City | PHOENIX
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State | AZ
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Zip | 85054-5632
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Country | US
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Telephone | 480-322-1987
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D012532
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License Number State | AZ
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