Individual
DR. BENJAMIN PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9351 IN-144, MARTINSVILLE, IN 46151
(765) 302-2128
Mailing address
351 CENTRAL STATE BLVD, INDIANAPOLIS, IN 46222-0105
(713) 480-2184
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12014785A
IN
1223G0001X
General Practice Dentistry
12014785A
IN
Other
Enumeration date
07/03/2025
Last updated
07/03/2025
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