Provider Demographics
NPI:1114224433
Name:DAWN M PHILLIPS DDSLLC
Entity Type:Organization
Organization Name:DAWN M PHILLIPS DDSLLC
Other - Org Name:CAMPUS HILLS DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:M
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-836-2253
Mailing Address - Street 1:2600 CHURCHVILLE RD
Mailing Address - Street 2:P.O. BOX 67
Mailing Address - City:CHURCHVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21028-1528
Mailing Address - Country:US
Mailing Address - Phone:410-836-2253
Mailing Address - Fax:410-734-0251
Practice Address - Street 1:2600 CHURCHVILLE RD
Practice Address - Street 2:
Practice Address - City:CHURCHVILLE
Practice Address - State:MD
Practice Address - Zip Code:21028-1528
Practice Address - Country:US
Practice Address - Phone:410-836-2253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-23
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty