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General NPI Number Information
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NPI Number | 1831266865
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Entity Type | Individual
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Provider Name | STEPHEN ADRIAN PHILLIPS DDS
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Gender | Male
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 04/23/2010
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Provider Practice Location Address
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Address Line | 4750 OKEMOS RD
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City | OKEMOS
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State | MI
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Zip | 48864-1637
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Country | US
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Telephone | 517-290-8360
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Fax |
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Provider Business Mailing Address
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Address Line | 3917 GORMAN AVE
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City | LANSING
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State | MI
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Zip | 48906
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Country | US
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Telephone | 517-327-4712
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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 | 2901017323
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License Number State | MI
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