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Organization
JOHN PHAM DDS PC
Active
Organization
JOHN PHAM DDS PC
Active
Other names
Hollywood Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN PHAM DDS (PRESIDENT)
(503) 331-1322
Entity
Organization
Contact information
Practice address
4301 NE TILLAMOOK, PORTLAND, OR 97213
(503) 331-1322
Mailing address
1515 NW LOUISIANA AVE, CHEHALIS, WA 98532
(360) 740-6212
(360) 740-6222
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D6843
OR
Other
Enumeration date
10/16/2006
Last updated
08/22/2020
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