Provider Demographics
NPI:1679873152
Name:BROWN, PHILLIP HAMBLEN (DMD)
Entity type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:HAMBLEN
Last Name:BROWN
Suffix:
Gender:M
Credentials:DMD
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Other - Credentials:
Mailing Address - Street 1:GREENVILLE TECHNICAL COLLEGE DENTAL PROGRAMS
Mailing Address - Street 2:506 S PLEASANTBURG DR
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-2416
Mailing Address - Country:US
Mailing Address - Phone:864-250-8595
Mailing Address - Fax:864-250-8261
Practice Address - Street 1:GREENVILLE TECHNICAL COLLEGE DENTAL PROGRAMS
Practice Address - Street 2:506 S PLEASANTBURG DR
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2416
Practice Address - Country:US
Practice Address - Phone:864-250-8595
Practice Address - Fax:864-250-8261
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2024-01-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WY982122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist