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1164944146
MATTHEW JOHN PHAN
ROSELLE, IL
NPI
1164944146
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: IL 019.032245)
Enumeration Date
2017-07-12
Last Update Date
2024-07-18
Business Address
DR. MATTHEW JOHN PHAN DDS
21 W IRVING PARK RD
ROSELLE, IL 60172-1117
Phone number: 805-813-9567
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Mailing Address
DR. MATTHEW JOHN PHAN DDS
21 W IRVING PARK RD
ROSELLE, IL 60172-1117
Phone number: 805-813-9567
Copy
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