Vickers, Phillip Dana
Vickers, Phillip Dana is an individual health care provider with primary practice located at 200 1St St Sw , Rochester MN 55905-0001. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Vickers, Phillip Dana can be contacted via phone (507) 284-2511.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | D10753 | Minnesota |
Profile Details
| NPI number | 1720149529 |
|---|---|
| LBN Legal business name | Vickers, Phillip Dana |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 13th, 2006 |
| Last updated | Jan 16th, 2024 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720149529 | NPPES |
| Minnesota | MEDICAID | 209324300 | |
| Minnesota | Other | 128G2VI |
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