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Organization
HUY B. PHAN DENTAL CORPORATION
Active
Organization
HUY B. PHAN DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HUY PHAN DDS (PRESIDENT)
(626) 758-0462
Entity
Organization
Contact information
Practice address
3351 TYLER AVE, EL MONTE, CA 91731-3101
(626) 279-5371
Mailing address
1024 PALOMA DR, ARCADIA, CA 91007-6124
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
46322
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G93443-01
MEDI-CAL PROVIDER NUMBER
CA
Enumeration date
02/16/2007
Last updated
08/06/2014
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