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General NPI Number Information
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NPI Number | 1851649248
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Entity Type | Organization
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Legal Business Name | DUNG Q PHAM DDS / CATHY H PHAM DDS
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Dates
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Enumeration Date | 08/16/2012
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Last Update Date | 07/10/2013
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Provider Practice Location Address
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Address Line | 1400 E 14TH ST STE E
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City | OAKLAND
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State | CA
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Zip | 94606-4493
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Country | US
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Telephone | 510-536-8000
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Fax | 510-532-3281
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Provider Business Mailing Address
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Address Line | 1400 E 14TH ST STE E
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City | OAKLAND
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State | CA
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Zip | 94606-4493
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Country | US
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Telephone | 510-536-8000
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DR. CATHY PHAM
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Credential | D.D. S
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Telephone | 510-536-8000
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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 | 42212
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 42494
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License Number State | CA
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