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NPI Code Detail

MEDICARE: TUAN D PHAM DMD & JOSEPH A MALONEY DDS, LLC

MEDICARE: TUAN D PHAM DMD & JOSEPH A MALONEY DDS, LLC
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 Dentistry13053MD

General Provider Information

NPI Number : 1558364208
Entity Type Code : Organization
Provider Name (Legal Business Name) : TUAN D PHAM DMD & JOSEPH A MALONEY DDS, LLC
Provider Business Mailing Address
First Line : 3450 OLD WASHINGTON RD
Second Line : STE 204
City : WALDORF
State : MD
Zip : 20602-3250
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3450 OLD WASHINGTON RD
Second Line : STE 204
City : WALDORF
State : MD
Zip : 20602-3250
Country : US
Telephone Number : 301-374-9033
Fax Number :
Authorized Official
Title or Position : OWNER
Name : TUAN PHAM
Credential : D.M.D.
Telephone Number : 301-374-9033
Provider Enumeration Date : 05/24/2005
Last Update Date : 12/01/2008

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