Individual
DR. CYNTHIA L JENNINGS PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
203 W WILSON ST, OTTUMWA, IA 52501-4725
(641) 682-2617
Mailing address
203 W WILSON ST, OTTUMWA, IA 52501-4725
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6873
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0204099
—
IA
Enumeration date
03/26/2007
Last updated
07/08/2007
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