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Individual
HAI THANH PHAN
Active
Individual
HAI THANH PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
49977
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49977
DELTA DENTAL
CA
01
—
B49977
DELTA DENTAL'HEALTHY FAMI
CA
01
—
G9315201
DENTICAL
CA
Enumeration date
07/15/2006
Last updated
08/23/2014
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