Provider Demographics
NPI:1598083487
Name:SARAH PHILLIPS, D.D.S., INC.
Entity Type:Organization
Organization Name:SARAH PHILLIPS, D.D.S., INC.
Other - Org Name:FAMILY TREE DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:661-254-1122
Mailing Address - Street 1:26415 CARL BOYER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-5829
Mailing Address - Country:US
Mailing Address - Phone:661-254-1122
Mailing Address - Fax:661-254-1123
Practice Address - Street 1:26415 CARL BOYER DR STE 200
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-5829
Practice Address - Country:US
Practice Address - Phone:661-254-1122
Practice Address - Fax:661-254-1123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-17
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53644261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental