Individual
JOHNATHAN PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2415 BLALOCK RD STE A, HOUSTON, TX 77080-2833
(713) 929-3532
Mailing address
8550 S BRAESWOOD BLVD STE B, HOUSTON, TX 77071-1110
(713) 363-1338
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
33298
TX
Other
Enumeration date
07/15/2017
Last updated
04/19/2023
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