MEDICARE: PHILLIP H. MABRY 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	377	AK

General Provider Information

NPI Number	:	1760533913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILLIP H. MABRY DDS

Provider Business Mailing Address
First Line	:	2601 BONIFACE PKWY
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99504-3106
Country	:	US
Telephone Number	:	907-337-9448
Fax Number	:

Provider Business Practice Location Address
First Line	:	2601 BONIFACE PKWY
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99504-3106
Country	:	US
Telephone Number	:	907-337-9448
Fax Number	:	907-337-4123

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

Provider Enumeration Date	:	01/15/2007
Last Update Date	:	06/21/2026

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