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General NPI Number Information
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NPI Number | 1245902634
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Entity Type | Organization
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Legal Business Name | HIEN NGOC PHAM DDS INC
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Dates
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Enumeration Date | 10/04/2021
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Last Update Date | 10/27/2021
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Provider Practice Location Address
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Address Line | 4857 E KINGS CANYON RD
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City | FRESNO
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State | CA
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Zip | 93727-3811
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Country | US
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Telephone | 559-251-7191
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Fax |
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Provider Business Mailing Address
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Address Line | 4857 E KINGS CANYON RD
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City | FRESNO
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State | CA
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Zip | 93727-3811
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Country | US
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Telephone | 559-251-7191
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HIEN NGOC PHAM
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Credential | DDS
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Telephone | 559-575-2266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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