Individual
DR. PHILLIP EARL BLEAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
300 TREMONT ST STE 6, CARVER, MA 02330-1761
(801) 557-1116
Mailing address
22 POWERS LN, HINGHAM, MA 02043-1432
(801) 557-1116
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN 1855376
MA
Other
Enumeration date
04/03/2009
Last updated
07/26/2012
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