Provider Demographics
NPI:1659458735
Name:PHILIPS, ROBERT J (DDS PA)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:PHILIPS
Suffix:
Gender:M
Credentials:DDS PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 W BELTLINE RD STE 7
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104
Mailing Address - Country:US
Mailing Address - Phone:972-293-1040
Mailing Address - Fax:972-293-6259
Practice Address - Street 1:130 W BELTLINE RD STE 7
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104
Practice Address - Country:US
Practice Address - Phone:972-293-1040
Practice Address - Fax:972-293-6259
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14233122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist