Individual
DR. KEVIN PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2855 LAWRENCEVILLE SUWANEE RD STE 360, SUWANEE, GA 30024-3596
(678) 482-2197
Mailing address
410 TAMBEC TRCE NW, LILBURN, GA 30047-2860
(404) 663-3146
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN123575
GA
Other
Enumeration date
08/14/2024
Last updated
11/13/2024
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