# DR. NGUYEN PHAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1407304959
- **Gender:** Man
- **Credential:** DMD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 32395 | TX | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | D011692 | AZ | Yes |

## Other

- **Enumeration date:** 09/13/2016
- **Last updated:** 05/05/2023