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General NPI Number Information
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NPI Number | 1477811958
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Entity Type | Organization
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Legal Business Name | TONYA L PHILLIPS, DDS, LLC
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Dates
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Enumeration Date | 05/02/2012
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Last Update Date | 08/28/2019
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Provider Practice Location Address
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Address Line | 1245 STATE ROUTE 598 STE B
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City | GALION
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State | OH
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Zip | 44833-9367
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Country | US
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Telephone | 419-468-1100
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Fax | 419-468-1104
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Provider Business Mailing Address
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Address Line | 1245 STATE ROUTE 598 STE B
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City | GALION
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State | OH
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Zip | 44833-9367
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Country | US
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Telephone | 419-468-1100
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Fax | 419-468-1104
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Authorized Official
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Title or Position | MEMBER/OWNER
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Name | DR. TONYA PHILLIPS
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Credential | DDS
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Telephone | 419-468-1100
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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 | 30022276
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License Number State | OH
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