Individual
DR. NATHAN ALEXANDER PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
301 OAK TREE LN, DAKOTA DUNES, SD 57049
(605) 242-0107
(605) 242-0145
Mailing address
301 OAK TREE LN, DAKOTA DUNES, SD 57049-5095
(605) 242-0107
(605) 242-0145
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
09366
IA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D1140
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548304710
BC/BS OF IA
IA
01
—
1548304710
BC/BS OF SD
SD
05
—
1548304710
—
IA
05
—
1548304710
—
SD
05
—
91201365400
—
NE
Enumeration date
01/18/2006
Last updated
08/21/2018
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