Organization
PALO VERDE DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THIHAN PHAN DDS (DENTIST)
(623) 322-9215
Entity
Organization
Contact information
Practice address
3400 N. DYSART RD, STE G125, AVONDALE, AZ 85392
(623) 322-9215
(623) 322-9251
Mailing address
3400 N. DYSART RD, STE G125, AVONDALE, AZ 85392
(623) 322-9215
(623) 322-9251
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
6412
AZ
Other
Enumeration date
01/22/2013
Last updated
01/22/2013
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