Provider Demographics
NPI:1386890903
Name:PHILIP H. IFFLAND, D.D.S., INC.
Entity type:Organization
Organization Name:PHILIP H. IFFLAND, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:IFFLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:330-478-0019
Mailing Address - Street 1:4912 HILLS AND DALES RD NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-1406
Mailing Address - Country:US
Mailing Address - Phone:330-478-0019
Mailing Address - Fax:
Practice Address - Street 1:4912 HILLS AND DALES RD NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-1406
Practice Address - Country:US
Practice Address - Phone:330-478-0019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.017097261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental