Provider Demographics
NPI:1518090802
Name:DANIEL E. PHILLIPS, D.D.S., P.L.L.C.
Entity Type:Organization
Organization Name:DANIEL E. PHILLIPS, D.D.S., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:585-334-5544
Mailing Address - Street 1:4001 E HENRIETTA RD
Mailing Address - Street 2:P.O. BOX 580
Mailing Address - City:HENRIETTA
Mailing Address - State:NY
Mailing Address - Zip Code:14467-9780
Mailing Address - Country:US
Mailing Address - Phone:585-334-5544
Mailing Address - Fax:585-334-6308
Practice Address - Street 1:4001 E HENRIETTA RD
Practice Address - Street 2:
Practice Address - City:HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14467-9780
Practice Address - Country:US
Practice Address - Phone:585-334-5544
Practice Address - Fax:585-334-6308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043684-1261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental