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General NPI Number Information
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NPI Number | 1669588778
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Entity Type | Organization
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Legal Business Name | PHYLLIS A. DIXON DDS PC
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 17W620 14TH ST STE. G
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City | OAKBROOK TERRACE
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State | IL
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Zip | 60181-3768
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Country | US
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Telephone | 630-629-8770
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Fax | 630-871-0484
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Provider Business Mailing Address
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Address Line | 17W620 14TH ST STE. G
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City | OAKBROOK TERRACE
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State | IL
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Zip | 60181-3768
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Country | US
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Telephone | 630-629-8770
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Fax | 630-871-0484
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. PHYLLIS A. DIXON
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Credential | DDS
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Telephone | 630-629-8770
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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 |
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License Number State | IL
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