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NPI Code Detail

MEDICARE: LYNH T PHAM, DDS PA

MEDICARE: LYNH T PHAM, DDS PA
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
11223G0001XGeneral Practice Dentistry19887TX

General Provider Information

NPI Number : 1538218219
Entity Type Code : Organization
Provider Name (Legal Business Name) : LYNH T PHAM, DDS PA
Provider Business Mailing Address
First Line : PO BOX 451177
Second Line :
City : GARLAND
State : TX
Zip : 75045-1177
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2811 S HAMPTON RD
Second Line : STE A
City : DALLAS
State : TX
Zip : 75224-2329
Country : US
Telephone Number : 214-467-4800
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : LYNH T PHAM
Credential :
Telephone Number : 469-767-0796
Provider Enumeration Date : 01/10/2007
Last Update Date : 06/26/2008

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