Roger A Phillips, D.M.D.

Individual provider Active NPI General Practice Dentistry · Hanover, NH

NPI 1386663334 · NPPES record last updated Jun 5, 2008

Key facts

NPI
1386663334
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2602 (NH)
Practice address
31 S Park St
Hanover, NH 03755-2131
Phone
(603) 643-3190
Fax
(603) 643-3017
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2602 NH Yes

Addresses

Primary practice location

31 S Park St
Hanover, NH 03755-2131

Mailing address

31 S Park St
Hanover, NH 03755-2131
Phone (603) 643-3190

Other providers in Hanover, NH

All providers in Hanover, NH · General Practice Dentistry in New Hampshire

Sources for this page

Verify at the official NPI Registry.