Provider Demographics
NPI:1629330972
Name:HAN, PHUU PWINT (DDS)
Entity Type:Individual
Prefix:DR
First Name:PHUU
Middle Name:PWINT
Last Name:HAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9866 GARVEY AVE
Mailing Address - Street 2:STE A
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91733-1289
Mailing Address - Country:US
Mailing Address - Phone:626-350-6222
Mailing Address - Fax:626-350-9881
Practice Address - Street 1:9866 GARVEY AVE STE A
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91733-1289
Practice Address - Country:US
Practice Address - Phone:626-350-6222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61423122300000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist