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General NPI Number Information
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NPI Number | 1710362132
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Entity Type | Individual
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Provider Name | PHILIP CARL VOISSEM DDS
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Gender | Male
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Dates
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Enumeration Date | 07/27/2015
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Last Update Date | 07/27/2015
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Provider Practice Location Address
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Address Line | 5005 S COOPER ST
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City | ARLINGTON
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State | TX
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Zip | 76017-5996
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Country | US
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Telephone | 817-405-2037
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Fax |
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Provider Business Mailing Address
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Address Line | 5619 GASTON AVE 213
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City | DALLAS
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State | TX
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Zip | 75214-4677
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Country | US
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Telephone | 217-779-2374
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 31086
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License Number State | TX
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