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NPI Code Detail

MEDICARE: DR. TRINH THU PHAM D.D.S.

MEDICARE: DR. TRINH THU PHAM D.D.S.
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
1122300000XDentist23144TX

General Provider Information

NPI Number : 1235268582
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TRINH THU PHAM D.D.S.
Provider Business Mailing Address
First Line : 5990 ARAPAHO RD APT 11D
Second Line :
City : DALLAS
State : TX
Zip : 75248-3722
Country : US
Telephone Number : 317-690-1303
Fax Number :
Provider Business Practice Location Address
First Line : 3501 SHEPHERD LN
Second Line :
City : BALCH SPRINGS
State : TX
Zip : 75180-2325
Country : US
Telephone Number : 972-286-5717
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2007
Last Update Date : 07/08/2007

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