Provider Demographics
NPI:1710025457
Name:SYRIBEYS, PHILIP J (DMD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:J
Last Name:SYRIBEYS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8097 ROSWELL RD
Mailing Address - Street 2:BUILDING E
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-6159
Mailing Address - Country:US
Mailing Address - Phone:770-393-4711
Mailing Address - Fax:
Practice Address - Street 1:8097 ROSWELL RD
Practice Address - Street 2:BUILDING E
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30350-6159
Practice Address - Country:US
Practice Address - Phone:770-393-4711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA012020122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist