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General NPI Number Information
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NPI Number | 1720434202
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Entity Type | Organization
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Legal Business Name | SERENITY DENTISTRY PLLC
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Dates
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Enumeration Date | 05/13/2016
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Last Update Date | 06/07/2019
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Provider Practice Location Address
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Address Line | 3535 RAYFORD RD
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City | SPRING
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State | TX
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Zip | 77386
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Country | US
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Telephone | 713-459-0834
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Fax |
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Provider Business Mailing Address
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Address Line | 3535 RAYFORD RD STE 300
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City | SPRING
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State | TX
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Zip | 77386-4491
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Country | US
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Telephone | 713-459-0834
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PHUONG QUOC PHAM
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Credential | DDS
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Telephone | 713-459-0834
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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 | 29084
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License Number State | TX
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