Individual
DR. BROCK PHILIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4540 SOUTHSIDE BLVD, SUITE 801, JACKSONVILLE, FL 32216-5492
(904) 642-2010
(904) 642-8282
Mailing address
4540 SOUTHSIDE BLVD, SUITE 801, JACKSONVILLE, FL 32216-5492
(904) 642-2010
(904) 642-8282
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN14354
FL
Other
Enumeration date
05/24/2010
Last updated
11/16/2011
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