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General NPI Number Information
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NPI Number | 1952558454
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Entity Type | Individual
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Provider Name | LANCHI NGOC PHAM DMD
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Gender | Female
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Dates
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Enumeration Date | 08/26/2008
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Last Update Date | 08/26/2008
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Provider Practice Location Address
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Address Line | 12732 BROOKHURST ST
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City | GARDEN GROVE
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State | CA
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Zip | 92840-4810
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Country | US
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Telephone | 714-539-8899
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Fax | 714-534-3053
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Provider Business Mailing Address
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Address Line | PO BOX 4919
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City | GARDEN GROVE
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State | CA
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Zip | 92842-4919
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Country | US
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Telephone | 714-539-8899
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Fax | 714-534-3053
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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 | 57639
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License Number State | CA
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