Individual
DR. MARK TUAN PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1201 N STONEWALL AVE RM 305, OKLAHOMA CITY, OK 73117-1214
(405) 271-5222
(405) 271-5831
Mailing address
6801 GREEN MEADOW LN, OKLAHOMA CITY, OK 73132-3957
(405) 596-2375
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5957
OK
Other
Enumeration date
06/29/2007
Last updated
07/08/2007
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