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Individual

MR. TRUNG PHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
4919 DOUGLAS AVE, SUITE #10, DES MOINES, IA 50310-2775
(515) 278-2010
Mailing address
1247 SUNSET ST, IOWA CITY, IA 52246-4943
(319) 471-7426

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DDS-09193
IA

Other

Enumeration date
06/24/2015
Last updated
06/24/2015
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