MEDICARE: DR. GREG S. PHILLIPS AND ASSOCIATES, LLC

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	3323	LA

General Provider Information

NPI Number	:	1861715864
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. GREG S. PHILLIPS AND ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	1960 JEFFERSON HWY
Second Line	:
City	:	LUTCHER
State	:	LA
Zip	:	70071-5119
Country	:	US
Telephone Number	:	225-869-4422
Fax Number	:	225-869-8306

Provider Business Practice Location Address
First Line	:	1960 JEFFERSON HWY
Second Line	:
City	:	LUTCHER
State	:	LA
Zip	:	70071-5119
Country	:	US
Telephone Number	:	225-869-4422
Fax Number	:	225-869-8306

Authorized Official
Title or Position	:	OWNER
Name	:	DR. GREG S PHILLIPS
Credential	:	DDS
Telephone Number	:	225-869-4422

Provider Enumeration Date	:	03/04/2010
Last Update Date	:	01/05/2026

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