Individual
DR. SHANE L. PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1355 N UNIVERSITY AVE. 330, PROVO, UT 84604
(801) 377-6453
Mailing address
1355 N UNIVERSITY AVE STE 330, PROVO, UT 84604-2721
(801) 377-6453
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
342924-9922
UT
Other
Enumeration date
02/27/2007
Last updated
04/04/2014
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