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General NPI Number Information
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NPI Number | 1912073719
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Entity Type | Organization
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Legal Business Name | PHILIP V HABAS DMD PSC
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1209 HIGHLAND AVE SUITE L
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City | CARROLLTON
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State | KY
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Zip | 41008
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Country | US
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Telephone | 502-732-5506
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 88 1209 HIGHLAND AVE SUITE L
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City | CARROLLTON
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State | KY
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Zip | 41008
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Country | US
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Telephone | 502-732-5506
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PHILIP VINCENT HABAS
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Credential | DMD
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Telephone | 502-732-5506
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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 | 5694
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License Number State | KY
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