Individual
MARK TERRANCE PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4024 8TH LN, ANOKA, MN 55303-1251
(507) 386-0288
Mailing address
4024 8TH LN, ANOKA, MN 55303-1251
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
D12534
MN
Other
Enumeration date
04/10/2008
Last updated
08/15/2012
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