Provider Demographics
NPI:1487815577
Name:JAMES J. PHILLIPS, JR., D.M.D., P.C.
Entity type:Organization
Organization Name:JAMES J. PHILLIPS, JR., D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:334-821-5291
Mailing Address - Street 1:761 N DEAN RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-4027
Mailing Address - Country:US
Mailing Address - Phone:334-821-5291
Mailing Address - Fax:334-821-5292
Practice Address - Street 1:761 N DEAN RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-4027
Practice Address - Country:US
Practice Address - Phone:334-821-5291
Practice Address - Fax:334-821-5292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL42511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty