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General NPI Number Information
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NPI Number | 1801558820
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Entity Type | Individual
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Provider Name | HUY PHAM DMD
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Gender | Male
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Dates
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Enumeration Date | 10/07/2021
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Last Update Date | 10/07/2021
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Provider Practice Location Address
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Address Line | 565 W OATES RD
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City | GARLAND
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State | TX
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Zip | 75043-5463
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Country | US
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Telephone | 214-473-5696
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Fax |
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Provider Business Mailing Address
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Address Line | 8917 CLEARLAKE DR
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City | ROWLETT
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State | TX
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Zip | 75088-6836
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Country | US
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Telephone | 214-435-4302
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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 | 37865
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License Number State | TX
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