The Tai Phan, DDS, MD

NPI #1407186562 in Porter Ranch, California

Provider Information

NPI Number: 1407186562
Entity Type: Individual
Name: The Tai Phan, DDS, MD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - Oral and Maxillofacial Surgery
Credential: DDS, MD
Enumeration Date: Jan 12, 2010
Last Updated: Jun 23, 2012

Practice Location

Address: 11200 CORBIN AVE
Address 2: SUITE #208
City: Porter Ranch
State: California
ZIP Code: 91326-4120
Phone: (818) 368-8522

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	1223S0112X	Primary

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