Organization
PHAMOUS SMILES FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAU M PHAM DMD (PRESIDENT & CEO)
(480) 216-2181
Entity
Organization
Contact information
Practice address
2470 W RAY RD STE 1, CHANDLER, AZ 85224-3557
(480) 899-5240
Mailing address
2136 E LA VIEVE LN, TEMPE, AZ 85284-3542
(480) 216-2181
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
Other
Enumeration date
03/19/2019
Last updated
03/19/2019
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