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General NPI Number Information
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NPI Number | 1508046327
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Entity Type | Organization
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Legal Business Name | ALIX PHILLIPS, DMD, INC.
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Dates
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Enumeration Date | 11/08/2007
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Last Update Date | 11/08/2007
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Provider Practice Location Address
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Address Line | 90 W CALLE DE LAS TIENDAS STE. 150
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City | GREEN VALLEY
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State | AZ
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Zip | 85614-4295
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Country | US
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Telephone | 520-393-7500
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Fax | 520-399-0147
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Provider Business Mailing Address
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Address Line | 90 W CALLE DE LAS TIENDAS STE. 150
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City | GREEN VALLEY
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State | AZ
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Zip | 85614-4295
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Country | US
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Telephone | 520-393-7500
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Fax | 520-399-0147
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | DR. VIRGINIA ALIX PHILLIPS
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Credential | DMD
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Telephone | 520-393-7500
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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 | 3837
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License Number State | AZ
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