# JAMES D. PHILLIPS, DMD,PSC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588832828
- **Authorized official:** JAMES D. PHILLIPS DMD (PRESIDENT)
- **Authorized official phone:** (270) 667-7301

## Contact information

- **Practice address:** 125 E MAIN ST, PROVIDENCE, KY 42450-1268
- **Practice address phone:** (270) 667-7301
- **Practice address fax:** (270) 667-7630
- **Mailing address:** 125 E MAIN ST, PROVIDENCE, KY 42450-1268
- **Mailing address phone:** (270) 667-7301
- **Mailing address fax:** (270) 667-7630

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 02/20/2008
- **Last updated:** 04/01/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 60038882 | — | KY |