Provider Demographics
NPI:1235412230
Name:PHILLIPSBURG ENDODONTICS
Entity type:Organization
Organization Name:PHILLIPSBURG ENDODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:ARCHIBLE
Authorized Official - Suffix:III
Authorized Official - Credentials:DMD
Authorized Official - Phone:862-763-0678
Mailing Address - Street 1:835 BELVIDERE RD
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-1384
Mailing Address - Country:US
Mailing Address - Phone:862-763-0678
Mailing Address - Fax:
Practice Address - Street 1:835 BELVIDERE RD
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1384
Practice Address - Country:US
Practice Address - Phone:862-763-0678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02331400261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental