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General NPI Number Information
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NPI Number | 1609936764
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Entity Type | Individual
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Provider Name | CINDY HUONG THU PHAM D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 01/11/2008
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Provider Practice Location Address
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Address Line | 7448 W GLENDALE AVE STE 126
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City | GLENDALE
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State | AZ
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Zip | 85303-2575
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Country | US
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Telephone | 623-930-0060
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Fax |
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Provider Business Mailing Address
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Address Line | 12568 W FLOWER ST
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City | AVONDALE
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State | AZ
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Zip | 85392-6376
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Country | US
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Telephone | 480-678-4699
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D6674
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License Number State | AZ
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