# DR JONATHAN R PHIPPS DMD PC

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

## Provider details

- **NPI number:** 1912183849
- **Authorized official:** DR. JONATHAN R PHIPPS DMD (PRESIDENT/DENTIST)
- **Authorized official phone:** (505) 836-0322

## Contact information

- **Practice address:** 6400 CENTRAL AVE SW, ALBUQUERQUE, NM 87105-2033
- **Practice address phone:** (505) 836-0322
- **Practice address fax:** (505) 836-2040
- **Mailing address:** 6400 CENTRAL AVE SW, ALBUQUERQUE, NM 87105-2033
- **Mailing address phone:** (505) 836-0322
- **Mailing address fax:** (505) 836-2040

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 1420 | NM | Yes |

## Other

- **Enumeration date:** 01/09/2008
- **Last updated:** 01/09/2008