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General NPI Number Information
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NPI Number | 1942374335
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Entity Type | Individual
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Provider Name | PHILIP GENE SEXTON D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 119 E CLINTON AVE
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City | MONMOUTH
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State | IL
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Zip | 61462-5710
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Country | US
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Telephone | 309-734-4913
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Fax | 309-734-4913
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Provider Business Mailing Address
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Address Line | 119 E CLINTON AVE P.O. BOX 887
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City | MONMOUTH
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State | IL
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Zip | 61462-5710
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Country | US
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Telephone | 309-734-4913
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Fax | 309-734-4913
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State | IL
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