Provider Demographics
NPI:1043202278
Name:KING, PHILIP JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:JOSEPH
Last Name:KING
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 475 , BOX 1821
Mailing Address - Street 2:US NAVAL HOSPITAL YOKOSUKA
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96350 1821
Mailing Address - Country:US
Mailing Address - Phone:0118146-896-2800
Mailing Address - Fax:
Practice Address - Street 1:PSC 475 , BOX 1821
Practice Address - Street 2:US NAVAL HOSPITAL YOKOSUKA
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96350 1821
Practice Address - Country:US
Practice Address - Phone:0118146-896-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK41201223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics