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Individual
LONG NGOC PHUNG
Active
Individual
LONG NGOC PHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
60607
CA
1223G0001X
General Practice Dentistry
Primary
27527
TX
Other
Enumeration date
10/26/2011
Last updated
03/19/2017
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