Individual
DR. KEVIN TRONG PHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4550 COUNTRY CLUB RD, WINSTON SALEM, NC 27104-3518
(336) 542-2184
Mailing address
4755 COUNTRY CLUB RD APT 101K, WINSTON SALEM, NC 27104-3511
(337) 281-5824
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11999
NC
Other
Enumeration date
09/14/2020
Last updated
09/14/2020
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