Individual
THOMAS TUAN PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9184 E STOCKTON BLVD, ELK GROVE, CA 95624-9510
(916) 686-1101
Mailing address
9324 WINDING BROOK WAY, ELK GROVE, CA 95624-4091
(916) 685-5148
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
48847
CA
Other
Enumeration date
03/29/2007
Last updated
07/08/2007
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