Provider Demographics
NPI:1245609577
Name:WOODS, PHILLIP DEXTER (DDS, MPH)
Entity Type:Individual
Prefix:
First Name:PHILLIP
Middle Name:DEXTER
Last Name:WOODS
Suffix:
Gender:M
Credentials:DDS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 RIPLEY ST
Mailing Address - Street 2:APARTMENT 2105
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-7438
Mailing Address - Country:US
Mailing Address - Phone:619-204-4076
Mailing Address - Fax:
Practice Address - Street 1:WALTER REED NATIONAL MILITARY CTR
Practice Address - Street 2:BUILDING 2, ROOM 2661, 8960 BROWN DRIVE
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-0001
Practice Address - Country:US
Practice Address - Phone:301-295-4011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-16
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16041122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist