Organization
JOSEPH PHEN, DENTIST, A DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH PHEN D.D.S. (DENTIST)
(916) 691-6997
Entity
Organization
Contact information
Practice address
8351 ELK GROVE BLVD STE 300, ELK GROVE, CA 95758-5515
(916) 691-6997
Mailing address
8351 ELK GROVE BLVD STE 300, ELK GROVE, CA 95758-5515
(916) 691-6997
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
45172
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285691907
DENTISTRY
CA
Enumeration date
12/08/2014
Last updated
12/08/2014
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