Organization
PHAN DENTAL GROUP
Active
Other names
Atlantis Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. H. DERICK PHAN DDS (OWNER)
(408) 251-7901
Entity
Organization
Contact information
Practice address
7048 DUBLIN BLVD, DUBLIN, CA 94568-3017
(925) 833-0535
Mailing address
150 N JACKSON AVE STE 211, SAN JOSE, CA 95116-1908
(408) 251-7901
(408) 251-0991
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
—
—
1223X0008X
Oral and Maxillofacial Radiology Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
01/27/2022
Last updated
01/27/2022
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