Organization
DR. LONETTE S PHIPPS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENNIE L PHIPPS (CEO)
(205) 788-8889
Entity
Organization
Contact information
Practice address
2152 46TH PLACE ENSLEY, BIRMINGHAM, AL 35208-4602
(205) 788-8889
(208) 788-8890
Mailing address
2152 46TH PLACE ENSLEY, BIRMINGHAM, AL 35208-4602
(205) 788-8889
(208) 788-8890
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5045
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51538521
BLUE CROSS BLUE SHIELD
AL
Enumeration date
01/15/2008
Last updated
01/15/2008
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