Provider Demographics
NPI:1336269620
Name:PHILIP A. PHILBIN, D.D.S., P.A.
Entity Type:Organization
Organization Name:PHILIP A. PHILBIN, D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:AUGUST
Authorized Official - Last Name:PHILBIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-263-5600
Mailing Address - Street 1:226 LOOKOUT LN
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21409-6306
Mailing Address - Country:US
Mailing Address - Phone:410-757-1522
Mailing Address - Fax:410-263-9722
Practice Address - Street 1:104 FORBES ST
Practice Address - Street 2:SUITE 204
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1516
Practice Address - Country:US
Practice Address - Phone:410-263-5600
Practice Address - Fax:410-263-9722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09549174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1194874784OtherNPI