Provider Demographics
NPI:1942246095
Name:BARONE, PHILIP RALPH (DDS)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:RALPH
Last Name:BARONE
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 1:2417 WHISPERING OAKS CT
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-4366
Mailing Address - Country:US
Mailing Address - Phone:210-870-9513
Mailing Address - Fax:
Practice Address - Street 1:7 AMDS/SGPD
Practice Address - Street 2:DYESS AFB
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79607
Practice Address - Country:US
Practice Address - Phone:325-696-2304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX308231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice