Individual
DR. PHILLIP HA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
1700 MCHENRY AVE STE 16B, MODESTO, CA 95350-4319
(209) 238-9800
Mailing address
1700 MCHENRY AVE STE 16B, MODESTO, CA 95350-4319
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
105779
CA
Other
Enumeration date
08/05/2021
Last updated
10/22/2022
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