Individual
DR. ELTANLIA PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1201 LOWER FAYETTEVILLE RD, SUITE F, NEWNAN, GA 30265-6509
(770) 253-7800
(770) 253-7644
Mailing address
1201 LOWER FAYETTEVILLE RD, SUITE F, NEWNAN, GA 30265-6507
(770) 253-7800
(770) 253-7644
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
012468
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807838815B
—
GA
Enumeration date
09/27/2006
Last updated
06/13/2012
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