MEDICARE: HSPD PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1306709563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HSPD PLLC

Provider Business Mailing Address
First Line	:	875 E NINE MILE RD STE 13
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32514-1708
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	875 E NINE MILE RD STE 13
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32514-1708
Country	:	US
Telephone Number	:	334-657-7668
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. PAUL PHAM
Credential	:
Telephone Number	:	850-123-4567

Provider Enumeration Date	:	12/04/2025
Last Update Date	:	04/09/2026

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