Individual
JEFFREY MARK PHILLIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
22442 64TH AVE, SUITE B, OAKLAND GARDENS, NY 11364-2327
(718) 225-3103
Mailing address
224 42 64TH AVENUE, SUITE B, OAKLAND GARDENS, NY 11364
(718) 225-3103
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
037845
NY
Other
Enumeration date
09/30/2008
Last updated
09/30/2008
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