Provider Demographics
NPI:1861568891
Name:PHILIPP, RONALD G (DMD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:G
Last Name:PHILIPP
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 CENTERPOINT PARKWAY
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35215
Mailing Address - Country:US
Mailing Address - Phone:205-854-8093
Mailing Address - Fax:205-854-8507
Practice Address - Street 1:2525 CENTERPOINT PARKWAY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35215
Practice Address - Country:US
Practice Address - Phone:205-854-8093
Practice Address - Fax:205-854-8507
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL30611223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics