Individual
CRYSTAL L PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2610 SHASTEN ST, GROVE, OK 74344-4904
(918) 786-5735
Mailing address
2610 SHASTEN ST, GROVE, OK 74344-4904
(918) 786-5735
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5852
OK
Other
Enumeration date
10/19/2006
Last updated
06/17/2011
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