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NPI Code Detail

MEDICARE: DR. PHUONG-GIANG THI PHAM DDS

MEDICARE: DR. PHUONG-GIANG THI PHAM DDS
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
1122300000XDentistD11831MN
21223G0001XGeneral Practice DentistryD11831MN

General Provider Information

NPI Number : 1427047638
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PHUONG-GIANG THI PHAM DDS
Provider Business Mailing Address
First Line : 1026 7TH ST W
Second Line :
City : ST. PAUL
State : MN
Zip : 55102
Country : US
Telephone Number : 651-241-1110
Fax Number : 651-241-1127
Provider Business Practice Location Address
First Line : 1026 7TH ST W
Second Line :
City : SAINT PAUL
State : MN
Zip : 55102-3828
Country : US
Telephone Number : 651-241-1110
Fax Number : 651-241-1127
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2005
Last Update Date : 02/12/2018

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