Individual
DR. DAI CHINH PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5153
(505) 256-2778
Mailing address
12025 SULLIVAN CT NW, ALBUQUERQUE, NM 87114-6535
(505) 256-2778
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
6032
NE
Other
Enumeration date
07/16/2006
Last updated
07/08/2007
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