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Individual

DR. PHILIP EVAN MCKENZIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS, MS, FRCDC

Contact information

Practice address
3360 NORTHDALE BLVD NW, COON RAPIDS, MN 55448-1601
(763) 233-3322
Mailing address
2200 COUNTY ROAD C W STE 2210, ROSEVILLE, MN 55113-2551
(763) 233-3322

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
D13597
MN

Other

Enumeration date
07/23/2014
Last updated
12/07/2020
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