Provider Demographics
NPI:1225036759
Name:PHILLIPS, WILLIAM RALPH III (DDS, MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:RALPH
Last Name:PHILLIPS
Suffix:III
Gender:M
Credentials:DDS, MD
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Mailing Address - Street 1:8201 PRESTON RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-6203
Mailing Address - Country:US
Mailing Address - Phone:214-528-5500
Mailing Address - Fax:214-528-5510
Practice Address - Street 1:8201 PRESTON RD
Practice Address - Street 2:SUITE 260
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-6203
Practice Address - Country:US
Practice Address - Phone:214-528-5500
Practice Address - Fax:214-528-5510
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2013-03-07
Deactivation Date:2006-04-28
Deactivation Code:
Reactivation Date:2006-09-27
Provider Licenses
StateLicense IDTaxonomies
TXL7848204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery