Provider Demographics
NPI:1831233295
Name:PHILLIPS, RUTH HOLZMAN (DDS)
Entity type:Individual
Prefix:DR
First Name:RUTH
Middle Name:HOLZMAN
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:RUTH
Other - Middle Name:HOLZMAN
Other - Last Name:CLEMANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:9 HIGH WATER CT
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:SC
Mailing Address - Zip Code:29676-4110
Mailing Address - Country:US
Mailing Address - Phone:864-719-0440
Mailing Address - Fax:
Practice Address - Street 1:947 BYPASS HIGHWAY 123
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-4758
Practice Address - Country:US
Practice Address - Phone:864-482-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0104531223G0001X
SC87141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice