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Crystal L Phillips, DDS

Dentist in Grove, OK. Individual provider (NPI-1).

NPI number1124100243
StatusActive
Last updated in NPPESJun 17, 2011

Details

NPI
1124100243
Entity type
Individual (NPI-1)
Name
Crystal L Phillips
Credential
DDS
Sex
Female
Sole proprietor
No
Enumeration date
Oct 19, 2006
Last updated
Jun 17, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist5852OKYes

Practice location

2610 Shasten St
Grove, OK 74344-4904

Phone 918-786-5735

Mailing address

2610 Shasten St
Grove, OK 74344-4904

Phone 918-786-5735

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