Individual
PHUNG PHAM JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
520 W OAKLAND AVE, SUITE 6, JOHNSON CITY, TN 37604-1654
(423) 926-5800
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
(315) 454-6000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS0000009202
TN
Other
Enumeration date
06/17/2009
Last updated
03/03/2015
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