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NPI Code Detail

MEDICARE: DR. HUAI C PHEN DDS

MEDICARE: DR. HUAI C PHEN DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry4640NV

General Provider Information

NPI Number : 1851460539
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HUAI C PHEN DDS
Provider Business Mailing Address
First Line : 1703 GRAYSTONE CANYON AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-6311
Country : US
Telephone Number : 415-235-0456
Fax Number :
Provider Business Practice Location Address
First Line : 3163 N RAINBOW BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-4578
Country : US
Telephone Number : 702-656-2301
Fax Number : 702-656-2038
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2006
Last Update Date : 07/08/2007

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Directions to “ DR. HUAI C PHEN DDS” Practice Location

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