Shane L. Phillips, D.D.S. Valid NPI

Individual provider · General Practice Dentistry · Provo, UT

NPI

1700913894

Type

Individual (Type 1)

Primary specialty

General Practice Dentistry (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223G0001X

License number

342924-9922 (UT)

Sex

Male

Sole proprietor

Yes

Enumerated

2007-02-27

Last updated

2014-04-04