Individual
DR. WILSON PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1319 LINCOLN AVE, PROSPECT PARK, PA 19076-1216
(610) 532-5008
Mailing address
626 SNYDER AVE, PHILADELPHIA, PA 19148-2419
(267) 940-0300
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN002360
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN002360
PA STATE LICENSE NUMBER
PA
Enumeration date
06/07/2016
Last updated
06/01/2018
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