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Organization

NAM PHAN, DMD, INC

Active
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Organization

NAM PHAN, DMD, INC

Active
Other names
Pro Dentista Dental Group
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. TERESA HAYRAPETIAN (CONSULTANT)
(818) 262-6114
Entity
Organization

Contact information

Practice address
2634 CLARENDON AVE, HUNTINGTON PARK, CA 90255-4120
(323) 585-2777
Mailing address
2634 CLARENDON AVE, HUNTINGTON PARK, CA 90255-4120

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1881924298
CA
Enumeration date
02/26/2010
Last updated
02/26/2010
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