Individual
CHUONG CONG PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
46161 WESTLAKE DR, SUITE 100, POTOMAC FALLS, VA 20165-5871
(703) 433-9999
(703) 433-9998
Mailing address
46161 WESTLAKE DR, SUITE 100, POTOMAC FALLS, VA 20165-5871
(703) 433-9999
(703) 433-9998
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401410435
VA
Other
Enumeration date
03/22/2007
Last updated
02/21/2024
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