Provider Demographics
NPI:1700963220
Name:PHILLIPS, CHRISTOPHER R E (DDS)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:R E
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 CHERRY AVE.
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024
Mailing Address - Country:US
Mailing Address - Phone:440-286-2474
Mailing Address - Fax:440-354-0811
Practice Address - Street 1:220 CHERRY AVE.
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024
Practice Address - Country:US
Practice Address - Phone:440-286-2474
Practice Address - Fax:440-576-0022
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300206901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice