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General NPI Number Information
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NPI Number | 1205470549
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Entity Type | Organization
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Legal Business Name | CHRISTINA PHAM DDS, LLC
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Dates
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Enumeration Date | 10/30/2019
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Last Update Date | 10/30/2019
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Provider Practice Location Address
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Address Line | 9328 JORDAN RD UNIT 109
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City | PARKER
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State | CO
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Zip | 80134-9313
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Country | US
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Telephone | 720-207-4201
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Fax |
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Provider Business Mailing Address
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Address Line | 15791 E PROGRESS DR
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City | CENTENNIAL
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State | CO
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Zip | 80015-4257
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Country | US
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Telephone | 720-207-4201
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTINA PHAM
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Credential | DDS
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Telephone | 720-207-4201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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