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Organization
REGENCY MODERN DENTISTRY, PA
Active
Organization
REGENCY MODERN DENTISTRY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MINH PHAM (OWNER)
(714) 845-8500
Entity
Organization
Contact information
Practice address
9406 ATLANTIC BLVD STE 1, JACKSONVILLE, FL 32225-8221
(904) 204-9105
Mailing address
PO BOX 660041, DALLAS, TX 75266-0041
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/02/2025
Last updated
06/02/2025
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