Individual
DR. JONATHAN ROBERT PHIPPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
6400 CENTRAL AVE SW, ALBUQUERQUE, NM 87105-2033
(505) 836-0322
Mailing address
2536 ELFEGO RD NW, ALBUQUERQUE, NM 87107-3011
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1420
NM
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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