MEDICARE: DR. MARILYN LIZ PHILLIPS-SMELTZER DDS

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
1	1223G0001X	General Practice Dentistry	8582	TN

General Provider Information

NPI Number	:	1588733026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARILYN LIZ PHILLIPS-SMELTZER DDS

Provider Business Mailing Address
First Line	:	1815 STUART AVE NW
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37311-4374
Country	:	US
Telephone Number	:	423-472-4621
Fax Number	:

Provider Business Practice Location Address
First Line	:	1815 STUART AVE NW
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37311-4374
Country	:	US
Telephone Number	:	423-472-4621
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	07/05/2022

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