Organization
TODAY DENTAL OFFICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STACY MAI PHAM D.D.S. (DENTIST OWNER)
(951) 687-4155
Entity
Organization
Contact information
Practice address
4000 TYLER ST, RIVERSIDE, CA 92503-3402
(951) 687-4155
Mailing address
4000 TYLER ST, RIVERSIDE, CA 92503-3402
(951) 687-4155
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
39461
CA
Other
Enumeration date
02/26/2007
Last updated
07/16/2014
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