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General NPI Number Information
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NPI Number | 1811106735
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Entity Type | Individual
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Provider Name | TRUC CHI THI PHAM DDS
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Gender | Female
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 2001 W ALAMEDA AVE
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City | DENVER
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State | CO
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Zip | 80223-1988
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Country | US
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Telephone | 303-937-7511
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Fax |
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Provider Business Mailing Address
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Address Line | 524 UNIVERSITY BLVD
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City | DENVER
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State | CO
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Zip | 80206-4127
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Country | US
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Telephone | 916-505-5054
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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 | 44354
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License Number State | CA
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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 | 00205044
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License Number State | CO
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