# EMILYPHAMDENTAL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578412953
- **Authorized official:** EMILY PHAM (MEMBER)
- **Authorized official phone:** (561) 232-4524

## Contact information

- **Practice address:** 723 SW PORT SAINT LUCIE BLVD., SUITE 102, PORT ST LUCIE, FL 34953
- **Practice address phone:** (772) 207-1990
- **Mailing address:** 723 SW PORT SAINT LUCIE BLVD., SUITE 102, PORT ST LUCIE, FL 34953
- **Mailing address phone:** (772) 207-1990

## Taxonomy

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

## Other

- **Enumeration date:** 01/27/2026
- **Last updated:** 01/27/2026