Provider Demographics
NPI:1427492586
Name:PHILLIPS, MARK C (DDS)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:C
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5101 COMMERCE DR
Mailing Address - Street 2:SUITE #102
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0411
Mailing Address - Country:US
Mailing Address - Phone:661-323-1500
Mailing Address - Fax:661-323-1767
Practice Address - Street 1:5101 COMMERCE DR
Practice Address - Street 2:SUITE #102
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0411
Practice Address - Country:US
Practice Address - Phone:661-323-1500
Practice Address - Fax:661-323-1767
Is Sole Proprietor?:No
Enumeration Date:2013-04-19
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA336481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice