Individual
WILLIAM A PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1001 DUPONT SQ N, LOUISVILLE, KY 40207-4612
(502) 897-0625
(502) 897-0627
Mailing address
1001 DUPONT SQ N, LOUISVILLE, KY 40207-4612
(502) 897-0625
(502) 897-0627
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
04017
KY
1223P0221X
Pediatric Dentistry
Primary
04017
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45602125
—
KY
05
—
60040177
—
KY
Enumeration date
10/20/2005
Last updated
10/08/2008
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