Individual
ELIZABETH MY ANH PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
9900 SW GREENBURG RD STE 240, TIGARD, OR 97223-5454
(971) 206-7133
(541) 516-4047
Mailing address
PO BOX 11470, EUGENE, OR 97440-3670
(888) 468-0022
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11140
OR
Other
Enumeration date
08/26/2019
Last updated
08/26/2019
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