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Dr. Philip R Banghart, DDS
Oral and Maxillofacial Surgery (Dentist) in Mattoon, Illinois
NPI 1982609087

Philip R Banghart is a Oral and Maxillofacial Surgery (Dentist) based in Mattoon, IL and is specialized in Oral and Maxillofacial Surgery. Philip R Banghart practices in Mattoon, IL and has the professional credentials of DDS. The NPI Number for Philip R Banghart is 1982609087 and holds a License No. 019-021176 (Illinois).

The current practice location address for Philip R Banghart is 102 Professional Plz, Mattoon, IL and can be reached out via phone at 217-345-7070 and via fax at 217-345-7077.

Location: 102 Professional Plz, Mattoon, IL, 61938-9252
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1982609087
Provider Name
Philip R Banghart
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
102 Professional Plz, Mattoon, IL, 61938-9252
Phone Number
217-345-7070
Fax Number
217-345-7077
Provider Enumeration Date
06/15/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
019-021176 05 IL
institution
Provider Business Practice Location Address Details
Address
102 Professional Plz
City
Mattoon
State
Illinois
Zip
61938-9252
Phone Number
217-345-7070
Fax Number
217-345-7077
person
Provider Business Mailing Address Details
Address
102 Professional Plz
City
Mattoon
State
Illinois
Zip
61938-9252
Phone Number
217-345-7070
Fax Number
217-345-7077
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
019-021176 (Illinois)
Definition
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
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