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Individual
DR. TRUNG QUANG PHAN
Active
Individual
DR. TRUNG QUANG PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
35899
TX
1223G0001X
General Practice Dentistry
DS041744
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
453991801
—
TX
Enumeration date
06/22/2018
Last updated
08/14/2023
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