Individual
CODY CLINTON PHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
126 CINEMA DR, WILMINGTON, NC 28403-1490
(910) 940-0259
Mailing address
126 CINEMA DR, WILMINGTON, NC 28403-1490
(910) 940-0259
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13237
NC
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/01/2023
Last updated
02/19/2026
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