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DR. PHILLIP MARTINE DRLICKA DDS

>> Dentist >> Dental Providers

Registrant NPI Number: 1942277793

Individual Registrant:
DR. PHILLIP MARTINE DRLICKA DDS
Gender: M
Sole Proprietor

Location and contact information for practice:
901 N WARRINGTON RD  PENSOCOLA, FL 32506 US
Tel: 850-455-1323  Fax: 850-453-2307

Contact information for business:
901N NEW WARRINGTON RD  PENSACOLA, FL 32506-4250 US
Tel: 850-455-1323  Fax: 850-453-2307

Registration Information:
NPI: 1942277793
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
FLDN12681

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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