Individual
TRANG PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2415 PACIFIC AVE SE, OLYMPIA, WA 98501-2065
(360) 556-6040
Mailing address
2415 PACIFIC AVE SE, OLYMPIA, WA 98501-2065
(360) 556-6040
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
62947
CA
1223P0221X
Pediatric Dentistry
62947
CA
1223P0221X
Pediatric Dentistry
Primary
DE60576762
WA
Other
Enumeration date
05/27/2015
Last updated
09/12/2015
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