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General NPI Number Information
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NPI Number | 1629692751
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Entity Type | Individual
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Provider Name | SARAH THI PHAM
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Gender | Female
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Dates
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Enumeration Date | 06/04/2020
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 924 COLONIAL AVE STE G
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City | YORK
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State | PA
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Zip | 17403-3450
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Country | US
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Telephone | 717-845-6687
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Fax |
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Provider Business Mailing Address
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Address Line | 920 CASTLEMAINE DR
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City | BIRMINGHAM
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State | AL
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Zip | 35226-5912
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Country | US
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Telephone |
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DS044295
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License Number State | PA
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