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Individual

MR. PHONG T DANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
9800 BROADWAY EXT STE 200, OKLAHOMA CITY, OK 73114-6304
(405) 715-4496
(405) 715-4499
Mailing address
5520 HIDDEN TRAIL LN, WARR ACRES, OK 73132-5825
(405) 473-5045

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3207
OK

Other

Enumeration date
08/24/2020
Last updated
08/24/2020
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