Individual
PHILIP BRUCE VICKERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2823 HIGHWAY 31 W, WHITE HOUSE, TN 37188-5241
(615) 672-3774
Mailing address
2823 HIGHWAY 31 W, WHITE HOUSE, TN 37188-5241
(615) 672-3774
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS 3220
TN
Other
Enumeration date
11/08/2006
Last updated
07/08/2007
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