Individual
DR. TRUC T PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
4229 LAFAYETTE CENTER DR, #1225, CHANTILLY, VA 20151-1261
(571) 214-6485
Mailing address
42648 BRADFORDS TELEGRAPH CT, CHANTILLY, VA 20152-6323
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401411128
VA
Other
Enumeration date
08/05/2007
Last updated
08/05/2007
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