MEDICARE: DR. HANH H PHI 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
1	1223D0001X	Public Health Dentistry	9549	CO
2	1223G0001X	General Practice Dentistry	9549	CO

General Provider Information

NPI Number	:	1386828929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HANH H PHI DDS

Provider Business Mailing Address
First Line	:	199 QUEBEC ST UNIT B
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-6186
Country	:	US
Telephone Number	:	720-935-5261
Fax Number	:

Provider Business Practice Location Address
First Line	:	199 QUEBEC ST UNIT B
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-6186
Country	:	US
Telephone Number	:	720-935-5261
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2007
Last Update Date	:	11/26/2012

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