Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 17648 | MA |
NPI | 1902910094 |
---|---|
Provider Name | Dr. Vincent Paul Phillipino |
First Address | Falmouth, MA 02540-2325 |
Second Address | Falmouth, MA 02540-2325 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 08/07/2007 |