Provider Demographics
NPI:1598913667
Name:MAGPANTAY, PHILIP JAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:JAY
Last Name:MAGPANTAY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8921 HARVEST SQUARE CT
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-4475
Mailing Address - Country:US
Mailing Address - Phone:240-899-1765
Mailing Address - Fax:
Practice Address - Street 1:198 THOMAS JOHNSON DR STE 18
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4452
Practice Address - Country:US
Practice Address - Phone:301-620-1117
Practice Address - Fax:301-620-9768
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14014122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist