Phan Dental Corp.

NPI #1649597170 in Porter Ranch, California

Provider Information

NPI Number: 1649597170
Entity Type: Organization
Organization Name: Phan Dental Corp.
Primary Specialty: Dentist
Enumeration Date: Apr 23, 2010
Last Updated: Apr 23, 2010

Practice Location

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

Authorized Official

Name: DR. BANG TAI PHAN, D.D.S.
Title: PRESIDENT
Phone: (818) 368-8522

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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