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Individual
PHIANH WALDON
Active
Individual
PHIANH WALDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12671
CT
1223E0200X
Endodontics
40035
TX
1223E0200X
Endodontics
Primary
DT-2895
HI
Other
Enumeration date
04/21/2020
Last updated
11/17/2023
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