Carl, Justin Jon Phillip

Carl, Justin Jon Phillip is an individual health care provider with primary practice located at 1225 Island Ave Unit 204 , San Diego CA 92101-7567. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Dental Providers / General Practice. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Carl, Justin Jon Phillip can be contacted via phone (209) 406-4508.

Contact Information

Primary practice address
1225 Island Ave Unit 204 San Diego CA 92101-7567
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 61913 California
Dental Providers / General Practice 1223G0001X 61913 California

Profile Details

NPI number 1609115336
LBN Legal business name Carl, Justin Jon Phillip
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2013
Last updated Jun 10th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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