Individual
DR. ANDREW KYANH PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
6919 SE 82ND AVE STE 103, TLC DENTISTRY, PORTLAND, OR 97266-5873
(503) 774-3546
(503) 774-3547
Mailing address
6919 SE 82ND AVE STE 103, TLC DENTISTRY, PORTLAND, OR 97266-5873
(503) 774-3546
(503) 774-3547
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
38733
CA
1223G0001X
General Practice Dentistry
Primary
D6465
OR
Other
Enumeration date
10/21/2008
Last updated
06/15/2012
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