Organization
JEFFEREY PHAM DENTAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFEREY PHAM DDS (CEO)
(714) 823-0854
Entity
Organization
Contact information
Practice address
7812 WARNER AVE, HUNTINGTON BEACH, CA 92647-4700
(714) 375-3222
(714) 375-3223
Mailing address
15701 SPAR ST, GARDEN GROVE, CA 92843-5353
(714) 823-0854
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
63830
CA
Other
Enumeration date
09/07/2017
Last updated
09/07/2017
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