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General NPI Number Information
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NPI Number | 1952488611
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Entity Type | Organization
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Legal Business Name | PHILLIPS AND NAGLE DDS LLC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 1201 AGORA DR SUITE 2B
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City | BEL AIR
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State | MD
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Zip | 21014-6859
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Country | US
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Telephone | 410-879-4363
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Fax | 410-836-5183
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Provider Business Mailing Address
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Address Line | 1201 AGORA DR SUITE 2B
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City | BEL AIR
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State | MD
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Zip | 21014-6859
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Country | US
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Telephone | 410-879-4363
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Fax | 410-836-5183
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | BIVIN PHILLIPS
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Credential | DDS
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Telephone | 410-879-4363
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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 | 10558
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License Number State | MD
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