# MAI T PHAN, DDS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912415647
- **Authorized official:** TUYET-MAI THI PHAN DDS (PRESIDENT)
- **Authorized official phone:** (703) 522-0510

## Contact information

- **Practice address:** 4001 9TH ST N STE 218, ARLINGTON, VA 22203-1900
- **Practice address phone:** (703) 522-0510
- **Practice address fax:** (703) 522-0511
- **Mailing address:** 4001 9TH ST N STE 218, ARLINGTON, VA 22203-1900
- **Mailing address phone:** (703) 522-0510
- **Mailing address fax:** (703) 522-0511

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | VA7134 | VA | Yes |

## Other

- **Enumeration date:** 01/16/2018
- **Last updated:** 01/16/2018