Provider Demographics
NPI:1528270436
Name:PAUL H. PHAN & ASSOCIATES, INC.
Entity type:Organization
Organization Name:PAUL H. PHAN & ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:HOANG
Authorized Official - Last Name:PHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-227-0085
Mailing Address - Street 1:5575 SIMMONS ST STE 10
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-9008
Mailing Address - Country:US
Mailing Address - Phone:702-317-7767
Mailing Address - Fax:702-310-5838
Practice Address - Street 1:5575 SIMMONS ST STE 10
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-9008
Practice Address - Country:US
Practice Address - Phone:702-317-7767
Practice Address - Fax:702-310-5838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3697122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty