Individual
CUONG TIEN PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7824 LAKE UNDERHILL RD, SUITE G, ORLANDO, FL 32822-8201
(407) 282-7498
(407) 658-2379
Mailing address
7824 LAKE UNDERHILL RD, SUITE G, ORLANDO, FL 32822-8201
(407) 282-7498
(407) 658-2379
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN15320
FL
Other
Enumeration date
08/14/2006
Last updated
07/08/2007
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