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General NPI Number Information
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NPI Number | 1467094185
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Entity Type | Organization
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Legal Business Name | DAVID PHAM DENTAL CORPORATION
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Dates
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Enumeration Date | 10/15/2019
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Last Update Date | 10/15/2019
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Provider Practice Location Address
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Address Line | 1000 E IMPERIAL HWY STE A1
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City | BREA
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State | CA
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Zip | 92821-5602
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Country | US
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Telephone | 714-257-6453
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 E IMPERIAL HWY STE A1
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City | BREA
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State | CA
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Zip | 92821-5602
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Country | US
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Telephone | 714-257-6453
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Fax |
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Authorized Official
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Title or Position | GENERAL DENTIST- OWNER
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Name | DR. DAVID H PHAM
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Credential | DDS
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Telephone | 714-330-1194
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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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