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Individual
DR. MAYNARD PRESCOTT PHELPS
Active
Individual
DR. MAYNARD PRESCOTT PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MS
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
0401411495
VA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
0401411495
VA
Other
Enumeration date
07/17/2006
Last updated
01/29/2024
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