Individual
MARK E PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
201 VAN GUNDY DR STE A, BRYAN, OH 43506-1179
(419) 636-4202
(419) 636-6976
Mailing address
201 VAN GUNDY DR STE A, BRYAN, OH 43506-1179
(419) 636-4202
(419) 636-6976
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13139
OH
Other
Enumeration date
02/12/2008
Last updated
02/12/2008
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