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General NPI Number Information
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NPI Number | 1518090802
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Entity Type | Organization
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Legal Business Name | DANIEL E. PHILLIPS, D.D.S., P.L.L.C.
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4001 E HENRIETTA RD
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City | HENRIETTA
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State | NY
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Zip | 14467-9780
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Country | US
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Telephone | 585-334-5544
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Fax | 585-334-6308
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Provider Business Mailing Address
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Address Line | 4001 E HENRIETTA RD P.O. BOX 580
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City | HENRIETTA
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State | NY
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Zip | 14467-9780
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Country | US
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Telephone | 585-334-5544
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Fax | 585-334-6308
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Authorized Official
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Title or Position | DENTIST
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Name | DR. DANIEL E. PHILLIPS
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Credential | D.D.S.
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Telephone | 585-334-5544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 043684-1
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License Number State | NY
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