Moritz, Phillip Vaughn

Moritz, Phillip Vaughn is an individual health care provider with primary practice located at 400 Willoughby Ave Ste 208 , Juneau AK 99801. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice. Dental Providers / Dentist is his primary health care specialty. Moritz, Phillip Vaughn can be contacted via phone (907) 586-1385.

Contact Information

Primary practice address
400 Willoughby Ave Ste 208 Juneau AK 99801
Phone: (907) 586-1385
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X AK0450 Alaska
Dental Providers / General Practice 1223G0001X AK0450 Alaska

Profile Details

NPI number 1649338393
LBN Legal business name Moritz, Phillip Vaughn
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2006
Last updated Jul 9th, 2007 - about 19 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649338393 NPPES
Alaska MEDICAID DD0450

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