Individual
DR. DAVID M PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
11237 FOLEY BLVD NW, COON RAPIDS, MN 55448-3389
(763) 757-3120
(763) 757-5161
Mailing address
1406 OSCEOLA AVE, APT #204, SAINT PAUL, MN 55105-2348
(651) 207-8780
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11114
MN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
D11114
MN
Other
Enumeration date
10/21/2005
Last updated
08/07/2014
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