Individual
PHILLIP S MCIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
304 IONA ST, FAIRMONT, NC 28340-1618
(910) 535-4316
(910) 535-4306
Mailing address
304 IONA ST, FAIRMONT, NC 28340-1618
(910) 535-4316
(910) 535-4306
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
051257
NY
122300000X
Dentist
Primary
8366
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051257
LICENCE NUMBER
NY
05
—
5907363
—
NC
Enumeration date
12/19/2006
Last updated
07/22/2024
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