Provider Demographics
NPI:1568857449
Name:DAWNPHILLIPSDDSLLC
Entity Type:Organization
Organization Name:DAWNPHILLIPSDDSLLC
Other - Org Name:CAMPUS HILLS DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-836-2253
Mailing Address - Street 1:1208 E CHURCHVILLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3442
Mailing Address - Country:US
Mailing Address - Phone:410-836-2253
Mailing Address - Fax:443-787-4106
Practice Address - Street 1:1208 E CHURCHVILLE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3442
Practice Address - Country:US
Practice Address - Phone:410-836-2253
Practice Address - Fax:443-787-4106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13549122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty