# AUTUMN FAMILY DENTISTRY, P.L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Autumn Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568813186
- **Authorized official:** DR. THIEN-KIM THI PHAM D.D.S. (DENTIST)
- **Authorized official phone:** (281) 678-8344

## Contact information

- **Practice address:** 2508 GULF FWY S STE 108, LEAGUE CITY, TX 77573-6743
- **Practice address phone:** (281) 678-8344
- **Mailing address:** 2508 GULF FWY S STE 108, LEAGUE CITY, TX 77573-6743
- **Mailing address phone:** (281) 678-8344

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/24/2016
- **Last updated:** 02/11/2020