Organization
PHILLIPS ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY JOSEPH PHILLIPS D.D.S, M.S. (ORTHODONTIST)
(608) 271-9293
Entity
Organization
Contact information
Practice address
5605 ODANA RD, MADISON, WI 53719-1207
(608) 271-9293
(608) 204-9216
Mailing address
5605 ODANA RD, MADISON, WI 53719-1207
(608) 271-9293
(608) 204-9216
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4603
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33722200
—
WI
Enumeration date
11/15/2006
Last updated
12/05/2014
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