Individual
TRAVIS PEMELTON PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1695 GOLDEN SPRINGS RD, ANNISTON, AL 36207-7097
(256) 831-1333
(256) 831-1837
Mailing address
1695 GOLDEN SPRINGS RD, ANNISTON, AL 36207-7097
(256) 831-1333
(256) 831-1837
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4871
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51520429
BLUE CROSS BLUE SHIELD
AL
01
—
971939
UNITED CONCORDIA
AL
Enumeration date
08/15/2006
Last updated
02/01/2013
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