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Individual

DR. BRIAN GIA SON PHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
13831 NW CORNELL RD, PORTLAND, OR 97229-5485
(503) 653-8320
Mailing address
13831 NW CORNELL RD, PORTLAND, OR 97229-5485

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10746
OR

Other

Enumeration date
11/10/2017
Last updated
03/06/2019
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