Individual
DR. NICHOLAS PHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
1450 SR 138, CONYERS, GA 30013
(404) 932-4705
Mailing address
1055 PAPER CREEK DR, LAWRENCEVILLE, GA 30046-5358
(404) 932-4705
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN014688
GA
Other
Enumeration date
10/10/2013
Last updated
10/10/2013
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