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Organization

CENTRA ONE DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HIEP DUY PHAM DDS (OWNER)
(713) 433-7500
Entity
Organization

Contact information

Practice address
4318 W FUQUA ST, HOUSTON, TX 77045-6204
(713) 433-7500
(713) 433-6245
Mailing address
4318 W FUQUA ST, HOUSTON, TX 77045-6204
(713) 433-7500
(713) 433-6245

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19860
TX

Other

Enumeration date
07/10/2008
Last updated
07/10/2008
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