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NPI Code Detail

MEDICARE: DR. MARK C PHILLIPS D.D.S.

MEDICARE: DR. MARK C PHILLIPS D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry33648CA

General Provider Information

NPI Number : 1427492586
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK C PHILLIPS D.D.S.
Provider Business Mailing Address
First Line : 5101 COMMERCE DR
Second Line : SUITE #102
City : BAKERSFIELD
State : CA
Zip : 93309-0411
Country : US
Telephone Number : 661-323-1500
Fax Number : 661-323-1767
Provider Business Practice Location Address
First Line : 5101 COMMERCE DR
Second Line : SUITE #102
City : BAKERSFIELD
State : CA
Zip : 93309-0411
Country : US
Telephone Number : 661-323-1500
Fax Number : 661-323-1767
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2013
Last Update Date : 04/19/2013

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