IndividualActive
Charles Phillips, DD
NPI 1912091935 · General Practice Dentistry · Kodiak, AK
Provider details
- NPI number
- 1912091935
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Credential
- DD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 1169 (AK)
Specialties & taxonomies
Dental Providers
Practice location
3449 E Rezanof Dr
Kodiak, AK 99615-6952
Phone: (907) 486-9800
Fax: (907) 486-9898
Approximate (ZIP-level) locationGet directions
Mailing address
3449 E Rezanof Dr
Kodiak, AK 99615-6952
Registry dates
- Enumerated
- 2006-10-03
- Last updated
- 2007-07-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.