Individual
DR. MARY BERNADETTE PHILP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5205 SHORELINE DRIVE, MOUND, MN 55364
(952) 472-7717
(612) 392-7915
Mailing address
5205 SHORELINE DRIVE, MOUND, MN 55364
(952) 472-7717
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D13148
MN
122300000X
Dentist
R514
MN
Other
Enumeration date
07/25/2011
Last updated
10/03/2012
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