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Organization

TIMOTHY M PHILLIPS DDS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TIMOTHY MICHAEL PHILLIPS DDS (GENERAL DENTIST)
(330) 948-1243
Entity
Organization

Contact information

Practice address
115 BANK ST, LODI, OH 44254-1001
(330) 948-1243
(330) 948-4706
Mailing address
115 BANK ST, LODI, OH 44254-1001
(330) 948-1243
(330) 948-4706

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30.025077
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0220616
OH
Enumeration date
05/24/2018
Last updated
05/24/2018
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