Individual
MS. ROENIKYA L. PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD, MPH
Contact information
Practice address
303 HOSPITAL DR, CLEVELAND, MS 38732
(662) 843-5011
Mailing address
210 S CHRISMAN AVE # 730, CLEVELAND, MS 38732-3316
(662) 801-6863
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
3607-11
MS
1223P0221X
Pediatric Dentistry
Primary
PEDO-535-17
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04753806
—
MS
Enumeration date
07/28/2011
Last updated
02/05/2019
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