Individual
DR. CORNELIA ANN MOORE PHILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2329 S WW WHITE RD, SAN ANTONIO, TX 78222-1936
(210) 648-2451
(210) 648-4140
Mailing address
2329 S WW WHITE RD, SAN ANTONIO, TX 78222-1936
(210) 648-2451
(210) 648-4140
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18776
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159776701
—
TX
Enumeration date
10/03/2006
Last updated
07/07/2009
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