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General NPI Number Information
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NPI Number | 1750902029
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Entity Type | Organization
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Legal Business Name | IBRITE DENTAL OFFICE OF CELINE T PHAM DDS INC
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Dates
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Enumeration Date | 04/28/2020
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Last Update Date | 12/23/2020
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Provider Practice Location Address
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Address Line | 5210 W 1ST ST STE F
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City | SANTA ANA
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State | CA
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Zip | 92703-3000
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Country | US
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Telephone | 714-554-6878
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Fax | 714-554-2957
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Provider Business Mailing Address
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Address Line | 5210 W 1ST ST STE F
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City | SANTA ANA
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State | CA
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Zip | 92703-3000
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Country | US
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Telephone | 714-554-6878
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Fax | 714-554-2957
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Authorized Official
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Title or Position | CEO
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Name | DR. CELINE THANH PHAM
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Credential |
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Telephone | 714-251-3851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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