Provider Demographics
NPI:1851453260
Name:MACFARLAND, PHILIP (DDS)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:
Last Name:MACFARLAND
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 1:304 MONTGOMERY AVE
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-4115
Mailing Address - Country:US
Mailing Address - Phone:734-981-4040
Mailing Address - Fax:734-981-2683
Practice Address - Street 1:42301 CHERRY HILL RD
Practice Address - Street 2:SUITE D
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48188-9801
Practice Address - Country:US
Practice Address - Phone:734-981-4040
Practice Address - Fax:734-981-2683
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010154271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice