Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 6779 | NC |
NPI | 1255437281 |
---|---|
Provider Name | Dr. Julie Anne Phillips |
First Address | Greensboro, NC 27401 |
Second Address | Greensboro, NC 27401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 26/09/2019 |