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General NPI Number Information
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NPI Number | 1558434563
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Entity Type | Individual
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Provider Name | THOMAS D PHAM DDS
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Gender | Male
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 11/02/2016
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Provider Practice Location Address
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Address Line | 158 138TH ST S.
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City | TACOMA
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State | WA
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Zip | 98444
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Country | US
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Telephone | 253-531-3414
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Fax | 253-539-1272
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Provider Business Mailing Address
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Address Line | 23006 MOUNTAIN HWY S.
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City | SPANAWAY
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State | WA
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Zip | 98387
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Country | US
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Telephone | 253-780-4982
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Fax | 253-539-1272
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DE00010639
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License Number State | WA
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