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General NPI Number Information
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NPI Number | 1629315452
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Entity Type | Organization
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Legal Business Name | PHAM, NGUYEN, ANWAR PLLC
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Dates
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Enumeration Date | 01/14/2013
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Last Update Date | 01/14/2013
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Provider Practice Location Address
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Address Line | 3704 172ND ST NE STE E
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City | ARLINGTON
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State | WA
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Zip | 98223-6336
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Country | US
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Telephone | 425-773-4909
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Fax |
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Provider Business Mailing Address
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Address Line | 3704 172ND ST NE STE E
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City | ARLINGTON
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State | WA
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Zip | 98223-6336
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Country | US
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Telephone | 425-773-4909
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Fax |
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Authorized Official
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Title or Position | MEMBER/OWNER
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Name | DR. TAMEEM ANWAR
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Credential |
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Telephone | 425-773-4909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DE00010639
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DE00009939
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DE00010340
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License Number State | WA
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