Individual
DR. MATTHEW JOHN PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
21 W IRVING PARK RD, ROSELLE, IL 60172-1117
(805) 813-9567
Mailing address
21 W IRVING PARK RD, ROSELLE, IL 60172-1117
(805) 813-9567
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.032245
IL
Other
Enumeration date
07/12/2017
Last updated
07/18/2024
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