Individual
DR. DAVID PHELPS JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
341 GRUNNION AVE, BRANCH DENTAL CLINIC, GROTON, CT 06349-5050
(860) 694-2377
(860) 694-2590
Mailing address
ROUTE 12 BLDG 449, ATTN PROFESSIONAL AFFAIRS, GROTON, CT 06349-5600
(860) 694-2377
(860) 694-2590
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2861
NV
Other
Enumeration date
11/16/2005
Last updated
07/08/2007
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