Phen, Jeffrey

Phen, Jeffrey is an individual health care provider with primary practice located at 850 W March Ln Suite B, Stockton CA 95207-6207. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Phen, Jeffrey can be contacted via phone (209) 474-0888.

Contact Information

Primary practice address
850 W March Ln Suite B Stockton CA 95207-6207
Phone: (209) 474-0888
Fax: (209) 474-3342
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 44988 California

Profile Details

NPI number 1043262744
LBN Legal business name Phen, Jeffrey
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Jul 8th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043262744 NPPES
California Other 000604467 UNITED CONCORDIA
California MEDICAID G91849 UNITED CONCORDIA

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