Organization
LONG D PHAM DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NOHEMI NOLASCO (RECEPTIONIST)
(703) 237-7820
Entity
Organization
Contact information
Practice address
462 HERNDON PKWY, HERNDON, VA 20170-5233
(703) 707-8500
(571) 210-4410
Mailing address
462 HERNDON PKWY, HERNDON, VA 20170-5233
(703) 707-8500
(571) 210-4410
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401412166
VA
Other
Enumeration date
10/23/2015
Last updated
10/23/2015
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