Individual
DR. VAN PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
6319 JONESBORO RD STE A, MORROW, GA 30260-1730
(832) 420-3772
Mailing address
6319 JONESBORO RD STE A, MORROW, GA 30260-1730
(770) 703-4205
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN122378
GA
1223G0001X
General Practice Dentistry
Primary
DN122378
GA
Other
Enumeration date
07/06/2021
Last updated
12/28/2021
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