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General NPI Number Information
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NPI Number | 1912507948
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Entity Type | Organization
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Legal Business Name | ALEXANDER PHILLIPS DDS INC
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Dates
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Enumeration Date | 10/28/2020
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Last Update Date | 10/28/2020
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Provider Practice Location Address
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Address Line | 120 C AVE STE 100
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City | CORONADO
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State | CA
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Zip | 92118-1992
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Country | US
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Telephone | 619-435-6231
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Fax | 619-435-8234
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Provider Business Mailing Address
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Address Line | 120 C AVE STE 100
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City | CORONADO
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State | CA
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Zip | 92118-1992
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Country | US
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Telephone | 619-435-6231
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Fax | 619-435-8234
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALEXANDER PHILLIPS
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Credential | DDS
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Telephone | 626-808-2497
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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 |
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