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Organization
SD- 4315FREDERICK PC
Active
Organization
SD- 4315FREDERICK PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYNHTHY THY PHAM DDS (PRESIDENT)
(214) 718-6052
Entity
Organization
Contact information
Practice address
4522 FREDERICKSBURG RD, A28, SAN ANTONIO, TX 78201-6547
(210) 530-8841
(210) 530-8738
Mailing address
10901 GARLAND RD, DALLAS, TX 75218-2613
(214) 466-1400
(214) 367-5896
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19887
TX
Other
Enumeration date
10/21/2016
Last updated
12/17/2021
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