Individual
THIHAN PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3400 N DYSART RD, UNIT G-125, AVONDALE, AZ 85392-1003
(623) 322-9215
(623) 322-9251
Mailing address
3400 N DYSART RD, UNIT G-125, AVONDALE, AZ 85392-1003
(623) 322-9215
(623) 322-9251
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6412
AZ
Other
Enumeration date
02/02/2007
Last updated
08/13/2009
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