Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. PHILIP R BANGHART, D.D.S.
Active Sole ProprietorDR. PHILIP R BANGHART, D.D.S. is a Oral & Maxillofacial Surgery healthcare provider located in MATTOON, Illinois. NPI 1982609087 is currently active in the NPPES registry. Verify at CMS.
Oral & Maxillofacial Surgery · MATTOON, IL
Registration Details
- NPI Number
- 1982609087
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 15, 2005 (21.184259552895 yrs)
- Last Updated
- Nov 10, 2008
- License
-
019-021176 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
102 PROFESSIONAL PLZMATTOON, IL, 619389252Browse IL providers · Browse ZIP 61938
- Phone
- 2173457070
- Fax
- 2173457077
- Primary Specialty
-
Oral & Maxillofacial Surgery
1223S0112X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.