Provider Demographics
NPI:1043262967
Name:BATTON, PHILIP JAY (DDS)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:JAY
Last Name:BATTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-2616
Mailing Address - Country:US
Mailing Address - Phone:317-392-2273
Mailing Address - Fax:
Practice Address - Street 1:11 HOWARD ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-2616
Practice Address - Country:US
Practice Address - Phone:317-392-2273
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12007319A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist