Individual
THAO THI THU PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
508 N CHURCH ST # 100, LIVINGSTON, TN 38570-1539
(931) 823-3754
Mailing address
9647 WOODLAND BROOK LN S, CORDOVA, TN 38018-3648
(931) 261-7166
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12543
TN
Other
Enumeration date
06/29/2024
Last updated
06/29/2024
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