PHILLIP R DOUGLAS

EAU CLAIRE, WI
NPI1982858247
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy122300000X Dentist
(Licence: IN  12011180A)
Additional Taxonomies122300000X Dentist
(Licence: WI  6330)
Enumeration Date2008-11-12
Last Update Date2009-04-15
Business Address
Dr. PHILLIP R DOUGLAS dds
4850 KEYSTONE XING
EAU CLAIRE, WI 54701-5076
Phone number: 715-855-1020
Mailing Address
Dr. PHILLIP R DOUGLAS dds
4850 KEYSTONE XING
EAU CLAIRE, WI 54701-5076
Phone number: 715-855-1020
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