Individual
DR. RITA DIANA PHILIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
6226 14TH AVE, KENOSHA, WI 53143-4413
(262) 656-0044
Mailing address
6226 14TH AVE, KENOSHA, WI 53143-4413
(262) 656-0044
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019028715
IL
122300000X
Dentist
1001144-15
WI
Other
Enumeration date
11/09/2007
Last updated
03/21/2025
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