Individual
DR. VANESSA PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
3596 HILL STREET, CLARKSTON, GA 30021
(404) 499-2216
Mailing address
3596 HILL STREET, CLARKSTON, GA 30021
(404) 499-2216
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
012128
GA
Other
Enumeration date
03/20/2008
Last updated
03/20/2008
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