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Organization
MINH PHAN DDS PA
Active
Organization
MINH PHAN DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MINH H PHAN (PRESIDENT)
(713) 473-7223
Entity
Organization
Contact information
Practice address
123 W SOUTHMORE, PASADENA, TX 77502
(713) 473-0058
(713) 473-0636
Mailing address
905 SOUTHMORE, PASADENA, TX 77502
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19016
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180693701
—
TX
01
—
G6010102
DELTA DENTAL
TX
Enumeration date
04/16/2007
Last updated
11/08/2011
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