Provider Demographics
NPI:1548388978
Name:VANMETER, PHILLIP PATRICK (DMD)
Entity Type:Individual
Prefix:
First Name:PHILLIP
Middle Name:PATRICK
Last Name:VANMETER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 EASTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42103-1688
Mailing Address - Country:US
Mailing Address - Phone:270-781-2772
Mailing Address - Fax:270-781-2809
Practice Address - Street 1:627 EASTWOOD AVE
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42103-1688
Practice Address - Country:US
Practice Address - Phone:270-781-2772
Practice Address - Fax:270-781-2809
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4647122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist