Organization
PHUONG C. HUYNH, DDS, INC.
Active
Organization
PHUONG C. HUYNH, DDS, INC.
Active
Other names
MISSION ORAL & MAXILLOFACIAL SURGERY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHUONG C HUYNH DDS (CEO)
(951) 354-6667
Entity
Organization
Contact information
Practice address
10683 MAGNOLIA AVE STE D, RIVERSIDE, CA 92505-1893
(951) 354-6667
(951) 354-8768
Mailing address
10683 MAGNOLIA AVE STE D, RIVERSIDE, CA 92505-1893
(951) 354-6667
(951) 354-8768
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
49336
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015916
DELTACARE PMI
—
01
—
1687889
UNITED CONCORDIA
—
01
—
57734
SAFEGUARD
—
Enumeration date
09/21/2006
Last updated
08/22/2020
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