Individual
EMILY PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
30.025107
OH
390200000X
Student in an Organized Health Care Education/Training Program
Y3156130
CA
Other
Enumeration date
04/21/2017
Last updated
09/30/2019
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