Individual
DR. JACQUELYN KHANH-PHUONG DO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
50-052365
NY
1223P0221X
Pediatric Dentistry
Primary
61081
CA
Other
Enumeration date
04/16/2007
Last updated
03/26/2019
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