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General NPI Number Information
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NPI Number | 1326534934
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Entity Type | Individual
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Provider Name | DR. TUVY L PHAN
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Gender | Female
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Dates
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Enumeration Date | 07/06/2018
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Last Update Date | 07/06/2018
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Provider Practice Location Address
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Address Line | 2300 PINE RIDGE RD
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City | NAPLES
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State | FL
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Zip | 34109-2006
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Country | US
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Telephone | 888-610-0465
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Fax |
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Provider Business Mailing Address
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Address Line | 9775 SW 125TH AVE
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City | MIAMI
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State | FL
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Zip | 33186-2434
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Country | US
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Telephone | 469-583-8213
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN23651
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License Number State | FL
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