Individual
DR. PHIL S SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
208 GLENWOOD AVE, KINSTON, NC 28501-3842
(252) 527-5333
Mailing address
208 GLENWOOD AVE, KINSTON, NC 28501-3842
(252) 527-5333
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2731
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
89016ER
GROUP NUMBER
NC
05
—
8997557
—
NC
01
—
97557
BLUE CROSS BLUE SHIELD
NC
Enumeration date
12/04/2006
Last updated
07/08/2007
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