Healthcare Provider Details

I. General information

NPI: 1306709563
Provider Name (Legal Business Name): HSPD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 E NINE MILE RD STE 13
PENSACOLA FL
32514-1708
US

IV. Provider business mailing address

875 E NINE MILE RD STE 13
PENSACOLA FL
32514-1708
US

V. Phone/Fax

Practice location:
  • Phone: 334-657-7668
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. PAUL PHAM
Title or Position: MANAGER
Credential:
Phone: 334-657-7668