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General NPI Number Information
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NPI Number | 1235685124
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Entity Type | Individual
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Provider Name | JANELLE PHAM COMFORT D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/30/2016
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Last Update Date | 08/19/2020
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Provider Practice Location Address
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Address Line | 1200 N TUSTIN AVE STE 102
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City | SANTA ANA
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State | CA
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Zip | 92705-3535
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Country | US
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Telephone | 714-835-2215
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 N TUSTIN AVE STE 102
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City | SANTA ANA
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State | CA
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Zip | 92705-3535
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Country | US
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Telephone | 714-835-2215
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | 103621
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License Number State | CA
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