Provider Demographics
NPI:1689430522
Name:EAST SAC DENTAL, THE DENTAL OFFICE OF DR PAUL PHILLIPS & ASSOC., INC
Entity Type:Organization
Organization Name:EAST SAC DENTAL, THE DENTAL OFFICE OF DR PAUL PHILLIPS & ASSOC., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-452-7874
Mailing Address - Street 1:1273 32ND ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5209
Mailing Address - Country:US
Mailing Address - Phone:916-452-7874
Mailing Address - Fax:
Practice Address - Street 1:1273 32ND ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5209
Practice Address - Country:US
Practice Address - Phone:916-452-7874
Practice Address - Fax:916-452-9139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty