Healthcare Provider Details

I. General information

NPI: 1376448381
Provider Name (Legal Business Name): WESMILEDENTAL LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3979 BUFORD HWY NE STE 122
ATLANTA GA
30345-1683
US

IV. Provider business mailing address

3979 BUFORD HWY NE STE 122
ATLANTA GA
30345-1683
US

V. Phone/Fax

Practice location:
  • Phone: 470-702-9000
  • Fax: 470-570-0524
Mailing address:
  • Phone: 470-702-9000
  • Fax: 470-570-0524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. THAO PHAM
Title or Position: DENTIST/OWNER
Credential: DMD
Phone: 470-702-9000